The Hyperglycemia and Adverse Pregnancy Outcome Study Associations of GDM and obesity with pregnancy outcomes

OBJECTIVEdTo determine associations of gestational diabetes mellitus (GDM) and obesity with adverse pregnancy outcomes in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study. RESEARCH DESIGN AND METHODSdParticipants underwent a 75-g oral glucose tolerance test (OGTT) between 24 and 32 weeks. GDM was diagnosed post hoc using Interna-tional Association of Diabetes and Pregnancy Study Groups criteria. Neonatal anthropometrics and cord serum C-peptide were measured. Adverse pregnancy outcomes included birth weight, newborn percent body fat, and cord C-peptide.90th percentiles, primary cesarean delivery, preeclampsia, and shoulder dystocia/birth injury. BMI was determined at the OGTT. Multiple logistic regression was used to examine associations of GDM and obesity with outcomes. RESULTSdMean maternal BMI was 27.7, 13.7 % were obese (BMI$33.0 kg/m2), and GDMwas diagnosed in 16.1%. Relative to non-GDM and nonobese women, odds ratio for birth weight.90th percentile forGDMalonewas 2.19 (1.93–2.47), for obesity alone 1.73 (1.50–2.00), and for bothGDM and obesity 3.62 (3.04–4.32). Results for primary cesarean delivery and preeclampsia and for cord C-peptide andnewbornpercent body fat.90thpercentileswere similar.Odds for birthweight.90t