The rising tide of obesity and diabetes: An evaluation of obesity and diabetes in pregnancy

Abstract

The prevalence of pregnant women with obesity and gestational diabetes (GDM) is rising. It is known that pregnant women with obesity and women with GDM have an increased risk of neonatal morbidity. This thesis describes the maternal characteristics of a sample of women in the Sydney Western region of New South Wales. The central aim of our study was to evaluate the association between obesity and gestational diabetes with maternal and neonatal outcomes in this cohort of women. Our initial study evaluated the association between obesity with maternal and neonatal outcomes over a four year time period. Obese women comprised 22% of the included 38917 women. Obese women had a higher likelihood of macrosomia (3.6%), p=0.001 and perinatal death (0.9%), p<0.05. Our second study evaluated gestational weight gain in women with gestational diabetes. A greater proportion of women that were either in the obese or overweight group (66%) gained weight above IOM guidelines at 36 weeks compared with normal pre-gravid BMI women (33%), p<0.001. Our third study evaluated the profile of a group of 30 women with GDM, and the effect of diet and physical activity advice during their pregnancy. There was a modest improvement in dietary behavior following dietetic/medical advice. Our study has demonstrated the adverse outcomes associated with obesity in pregnancy and in the group of women with GDM and/or obesity.