|
Excess weight in pregnant women, both before pregnancy and gainedduring pregnancy, is the main predictor of whether mothers willhave larger than average babies, which can result in increased riskof cesarean section or trauma during delivery, states a studypublished in CMAJ (Canadian Medical Association Journal). Women with diabetes in pregnancy or gestational diabetes are at increased risk ofhaving a large-for-gestational-age baby. Called macrosomia, it isdefined as an infant whose weight is above the 90th percentile ofCanadian fetal growth curves, or more than 4 kg. Current clinicalpractice focuses on managing glucose levels in women with theseconditions to reduce the risk of having larger babies. Recentstudies have shown a link between maternal glucose levels in womenwithout gestational diabetes and the risk of having a larger baby. Proposed new criteria suggest lowering the glucose levels fordiagnosing gestational diabetes to help identify women who might beat risk of having a large-for-gestational-age baby. To determine the effects of a variety of maternal factors such as obesity , glucose levels and lipid levels on infant birth weight,researchers from Mount Sinai Hospital, The Hospital for SickChildren (SickKids), University of Toronto, and St. Michael'sHospital, Toronto, conducted a study with 472 women - 368 withnormal glucose tolerance and 104 with impaired glucose tolerance. They found that excess weight before pregnancy and the amount ofweight gain during pregnancy were the strongest metabolicpredictors of whether a woman would have alarge-for-gestational-age baby. Elevated glucose levels had arelatively modest impact as did lipid levels. "Gestational impaired glucose tolerance was not a significantindependent predictor of having a large-for-gestational-ageinfant," writes Dr. Ravi Retnakaran, Mount Sinai Hospital, withcoauthors. "Similarly, none of the lipid measures was independentlyassociated with birth weight or large-for-gestational-age infant.These data suggest that maternal weight and its associatedcirculating factors have a greater impact on infant birth weightthan do mild glucose intolerance and lipid levels in women withoutgestational diabetes." "In the context of the current obesity epidemic, these data supportthe importance of targeting healthy body weight in young women as a strategy for reducing the risk of excessivefetal growth and infant macrosomia," conclude the authors."Furthermore, these findings suggest that, in the care ofoverweight or obese women in pregnancy, closer monitoring of weightgain during pregnancy may be warranted." In a related commentary, Dr. Edmond Ryan, University of Alberta,writes, "Recently proposed criteria [from the InternationalAssociation of Diabetes in Pregnancy Study Groups] for gestationaldiabetes will result in the condition being diagnosed in nearly afifth of all pregnancies... . Retnakaran and colleagues reportthat, among women who did not have gestational diabetes accordingto current diagnostic criteria, impaired glucose tolerance was nota significant independent predictor of having alarge-for-gestational-age infant." Dr. Ryan cautions that, "With the stroke of a consensus pen, nearly one-fifth of pregnant women - more thandouble the current incidence in Canada - would be labelled ashaving gestational diabetes if the criteria of the InternationalAssociation of Diabetes in Pregnancy Study Groups were to beadopted." He suggests that targeting weight issues may be a moreefficient use of health care resources. Additional References Citations. I am an expert from cobledlighting.com, while we provides the quality product, such as Led Pendant Lighting Manufacturer , Led Bathroom Lighting Fixtures Manufacturer, Cob Led Downlight,and more.
Related Articles -
Led Pendant Lighting Manufacturer, Led Bathroom Lighting Fixtures Manufacturer,
|
