The effect of maternal obesity on pregnancy outcomes of women with gestational diabetes controlled with diet only, glyburide, or insulin

Am J Perinatol. 2012 Sep;29(8):643-8. doi: 10.1055/s-0032-1314884. Epub 2012 May 29.

Abstract

Objective: To examine the effect of obesity on maternal and neonatal outcomes in women diagnosed with gestational diabetes mellitus (GDM) and managed with diet only, glyburide, or insulin.

Study design: Women with singleton gestations enrolled for outpatient services diagnosed with GDM and without history of pregnancy-related hypertension at enrollment or in a prior pregnancy were identified in a database. Women with GDM controlled by diet only (n = 3918), glyburide (n = 873), or insulin without prior exposure to oral hypoglycemic agents (n = 2229) were included. Pregnancy outcomes were compared for obese versus nonobese women within each treatment group and also compared across treatment groups within the obese and nonobese populations.

Results: Within each treatment group, obesity was associated with higher rates of cesarean delivery, pregnancy-related hypertension, macrosomia, and hyperbilirubinemia (all p < 0.05). Higher rates of pregnancy-related hypertension and hyperbilirubinemia were observed in women receiving glyburide.

Conclusion: Obesity adversely affects pregnancy outcome in women with GDM. Higher rates of pregnancy-related hypertension and hyperbilirubinemia were observed in pregnant women receiving glyburide.

Publication types

  • Comparative Study

MeSH terms

  • Comorbidity
  • Diabetes, Gestational / diet therapy
  • Diabetes, Gestational / epidemiology*
  • Diabetes, Gestational / therapy*
  • Female
  • Glyburide / therapeutic use*
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Insulin / therapeutic use*
  • Logistic Models
  • Obesity / epidemiology*
  • Pregnancy
  • Pregnancy Outcome / epidemiology*
  • Retrospective Studies
  • Risk Factors

Substances

  • Hypoglycemic Agents
  • Insulin
  • Glyburide