Gestational diabetes & diabetes in pregnancy
Pre-pregnancy body mass index and risk of maternal or infant complications with gestational diabetes mellitus as a mediator: A multicenter, longitudinal cohort study in China
Authors' conclusion
A high or low pBMI is associated with the risk for maternal or infant complications and partly mediated by GDM. A lower pBMI cutoff of 21 kg/m2 may be appropriate for risk for maternal or infant complications in pregnant Chinese women.
Study context
- Population
- Pregnant women from 24 hospitals in 15 provinces of China, enrolled 2017 and followed through 2018
- Participants
- 6,174 women
- Exposure
- Obese or underweight pBMI vs normal pBMI, with gestational diabetes mellitus (GDM) as mediator
- Outcome
- Maternal or infant complications by pBMI
Methodological detailspropensity score-based inverse probability of treatment weighting, causal mediation analysis, restricted cubic spline models, E-value method for unmeasured confounding
- Propensity score-based inverse probability of treatment weighting
- Causal mediation analysis
- Restricted cubic spline models
- E-value method for unmeasured confounding
Main finding
As reported in the abstract
Each group vs normal pBMIEstimate (95% CI)
Obese
OR (gestational hypertension) 5.38(3.48–8.34)
Obese
OR (macrosomia) 2.65(1.83–3.84)
Obese
OR (large for gestational age) 2.05(1.45–2.88)
Underweight
OR (low birth weight) 1.42(1.15–2.08)
Underweight
OR (small for gestational age) 1.62(1.23–2.11)
- Proportion of obesity–gestational hypertension association mediated by GDM
- 4.73% (95% CI: 0.57%-8.88%)
- Proportion of obesity–macrosomia association mediated by GDM
- 4.61% (95% CI: 0.51%-9.74%)
- Proportion of obesity–large for gestational age association mediated by GDM
- 5.02% (95% CI: 0.13%-10.18%)
Observational data: associations, not effects.
Further findings
Dose-response: pBMI tipping point for maternal or infant complications
- Appropriate tipping point pBMI in Chinese women
- 21.0 kg/m²
Original publication
Pre-pregnancy body mass index and risk of maternal or infant complications with gestational diabetes mellitus as a mediator: A multicenter, longitudinal cohort study in China. Diabetes Res Clin Pract. Published 9 March 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →