Body mass index has a greater impact on pregnancy outcomes than gestational hyperglycaemia

Diabetologia. 2005 Sep;48(9):1736-42. doi: 10.1007/s00125-005-1877-1. Epub 2005 Jul 29.


Aims/hypothesis: We evaluated diabetes-related pregnancy outcomes in a cohort of Spanish women in relation to their glucose tolerance status, prepregnancy BMI and other predictive variables.

Methods: The present paper is part of a prospective study to evaluate the impact of American Diabetes Association (2000) criteria in the Spanish population. A total of 9,270 pregnant women were studied and categorised as follows according to prepregnancy BMI quartiles and glucose tolerance status: (1) negative screenees; (2) false-positive screenees; (3) gestational diabetes mellitus (GDM) according to American Diabetes Association criteria only; and (4) GDM according to National Diabetes Data Group criteria (NDDG). We evaluated fetal macrosomia, Caesarean section and seven secondary outcomes as diabetes-related pregnancy outcomes. The population-attributable and population-prevented fractions of predictor variables were calculated after binary logistic regression analysis with multiple predictors.

Results: Both prepregnancy BMI and abnormal glucose tolerance categories were independent predictors of pregnancy outcomes. The upper quartile of BMI accounted for 23% of macrosomia, 9.4% of Caesarean section, 50% of pregnancy-induced hypertension and 17.6% of large-for-gestational-age newborns. In contrast, NDDG GDM accounted for 3.8% of macrosomia, 9.1% of pregnancy-induced hypertension and 3.4% of preterm births.

Conclusions/interpretation: In terms of population impact, prepregnancy maternal BMI exhibits a much stronger influence than abnormal blood glucose tolerance on macrosomia, Caesarean section, pregnancy-induced hypertension and large-for-gestational-age newborns.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Glucose / metabolism
  • Body Mass Index*
  • Cesarean Section / statistics & numerical data
  • Female
  • Fetal Macrosomia / epidemiology
  • Glucose Tolerance Test
  • Humans
  • Hyperglycemia / physiopathology*
  • Infant, Newborn
  • Male
  • Maternal Age
  • Pregnancy
  • Pregnancy Complications / physiopathology*
  • Pregnancy Outcome*
  • Spain


  • Blood Glucose