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Gestational diabetes mellitus and obesity: effects on offspring

https://doi.org/10.17749/2313-7347/ob.gyn.rep.2021.197

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Abstract

Aim: to identify the risk factors for gestational diabetes mellitus (GDМ) and predictors of perinatal lesions of central nervous system (CNS) in combination of GDМ and maternal obesity.

Materials and Methods. А retrospective observational case-control uncombined study was conducted to determine GDМ risk factors and their effect on perinatal pathology in 250  women divided into 2 groups. The main group included 150 pregnant women diagnosed with GDМ, the control group – 100 pregnant women without carbohydrate metabolism disorders. An assessment of hereditary, obstetric and gynecological history, somatic health was carried out. Patients of the main group were divided into smaller groups: 1А (n = 77) – mothers whose newborns postnatal had adverse perinatal outcomes associated with the influence of maternal hyperglycemia and 1В (n = 73) – mothers whose newborns were born healthy. CHAID method (Chi Squared Automatic Interaction Detection) was used to create an algorithm for predicting adverse perinatal outcomes in GDМ. Аt the second stage, a single-center prospective observational non-combined cohort study was conducted to assess the effect of maternal hyperglycemia on the formation of perinatal lesions of CNS. The concentration of neuron-specific enolase (NSE) was determined before the labor in the amniotic fluid of full-term fetuses in the group of pregnant women without carbohydrate metabolism disorders (n = 42) and in the group of pregnant women with GDM (n = 33).

Results. Obesity, late reproductive age, family history of diabetes mellitus type 2 (DM-2), abortions, early reproductive losses, large for gestational age fetuses in history are the main risk factors for GDM developing. An algorithm was developed that allowed the prediction of the risk of the newborn perinatal pathology in the mother with GDM. The concentration of NSE in the amniotic fluid of full-term fetuses before the onset of labor increases with a combination of GSD and obesity (5.56 [3.37–6.24] by 1.68 times compared to the concentration in pregnant women with normal weight without carbohydrate metabolism disorders (3.29 [1.49–4.89]) (p = 0,006). 

Conclusion. Pregnant women with obesity and a family history of DM-2 have the highest possibility of perinatal complications. Increasing the concentration of NSE in amniotic  fluid in patients with GDМ confirms damage to the fetal CNS in the antenatal  period. The maximum NSE level was determined in the combination of GSМ and obesity 

About the Authors

O. V. Rozhkova
Altai State Medical University, Health Ministry of Russian Federation; Altai Regional Clinical Perinatal Center «DAR»
Russian Federation

MD, Postgraduate Student, Department of Obstetrics and Gynecology with a
Course of Additional Professional Education; Obstetrician-Gynecologist,

40 Lenin Ave., Barnaul 656038, Russia

154 Fomina Str., Barnaul 656045, Russia



O. V. Remneva
Altai State Medical University, Health Ministry of Russian Federation; Altai Regional Clinical Perinatal Center «DAR»
Russian Federation

MD, Dr Sci Med, Associate Professor, Head of the Department of Obstetrics and Gynecology with a Course of Additional Professional Education; Consulting Physician 

40 Lenin Ave., Barnaul 656038, Russia

154 Fomina Str., Barnaul 656045, Russia



N. I. Fadeeva
Altai State Medical University, Health Ministry of Russian Federation
Russian Federation
MD, Dr Sci Med, Professor, Department of Obstetrics and Gynecology with a Course of Additional Professional Education

40 Lenin Ave., Barnaul 656038, Russia


Yu. V. Korenovskiy
Altai State Medical University, Health Ministry of Russian Federation
Russian Federation
MD, PhD, Associate Professor, Head of the Department of General and Biological Chemistry, Clinical Laboratory Diagnostics

40 Lenin Ave., Barnaul 656038, Russia


S. D. Yavorskaya
Altai State Medical University, Health Ministry of Russian Federation
Russian Federation
MD, Dr Sci Med, Associate Professor, Professor, Department of Obstetrics and Gynecology with a Course of Additional Professional Education

40 Lenin Ave., Barnaul 656038, Russia


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For citation:


Rozhkova O.V., Remneva O.V., Fadeeva N.I., Korenovskiy Yu.V., Yavorskaya S.D. Gestational diabetes mellitus and obesity: effects on offspring. Obstetrics, Gynecology and Reproduction. 0;. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2021.197

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ISSN 2313-7347 (Print)
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