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Tu Y, Li Y, Fan X, Gui Z, Dai J, Fang Q, Qiu T, Bai J, Liu Y. Combined impact of Hepatitis B virus and gestational diabetes mellitus on ultrasound-measured fetal growth and adverse perinatal outcomes: A seven-year retrospective study. Diabetes Res Clin Pract 2024; 207:111092. [PMID: 38219600 DOI: 10.1016/j.diabres.2024.111092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/06/2024] [Accepted: 01/09/2024] [Indexed: 01/16/2024]
Abstract
AIMS To investigate the impact of pregnancy with combined hepatitis B virus (HBV) infection and Gestational diabetes mellitus (GDM) on fetal growth and adverse perinatal outcomes. METHODS All the pregnant women with HBV infection and/or GDM who delivered at Women's Hospital, Zhejiang University between January 2015, and September 2022 were included. A total of 1633 pregnant women were recruited in the final analysis, including 409 women with HBV infection and GDM, 396 with HBV infection only, 430 with GDM only, and 398 without HBV infection and GDM. Linear and logistic regression models were used to study the impact of pregnancy with combined HBV infection and GDM on fetal growth and adverse perinatal outcomes. RESULTS Pregnancy with combined HBV infection and GDM was associated with increased Z-scores on primary fetal ultrasound parameters and significantly increased the risk of fetal femur length overgrowth (OR: 2.88, 95 % CI: 1.13 ∼ 7.35), placental abruption (OR: 3.64, 95 % CI: 1.18 ∼ 11.22), and macrosomia (OR: 4.19, 95 % CI: 1.66 ∼ 10.56) compared to pregnancy without HBV infection and GDM. CONCLUSIONS Both maternal HBV infection and GDM are independently associated with adverse perinatal outcomes. Their combination further increases the risk of adverse perinatal outcomes.
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Affiliation(s)
- Yiming Tu
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan 430071, China.
| | - Yanting Li
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan 430071, China.
| | - Xiaoxiao Fan
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan 430071, China.
| | - Zaidi Gui
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan 430071, China; Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China.
| | - Jiamiao Dai
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan 430071, China.
| | - Qingbo Fang
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan 430071, China.
| | - Tianlai Qiu
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan 430071, China.
| | - Jinbing Bai
- Emory University Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road, Atlanta, GA 30322, USA.
| | - Yanqun Liu
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan 430071, China.
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Chen C, Lei Z, Xiong Y, Ni M, He B, Gao J, Zheng P, Xie X, He C, Yang X, Cheng W. Gestational weight gain of multiparas and risk of primary preeclampsia: a retrospective cohort study in Shanghai. Clin Hypertens 2023; 29:32. [PMID: 38037134 PMCID: PMC10691081 DOI: 10.1186/s40885-023-00254-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 10/09/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND In all studies conducted so far, there was no report about the correlation between excessive gestational weight gain (GWG) and the risk of preeclampsia (PE) in multiparas, especially considering that multiparity is a protective factor for both excessive GWG and PE. Thus, the aim of this retrospective cohort study was to determine whether GWG of multiparas is associated with the increased risk of PE. METHODS This was a study with 15,541 multiparous women who delivered in a maternity hospital in Shanghai from 2017 to 2021, stratified by early-pregnancy body mass index (BMI) category. Early-pregnancy body weight, height, week-specific and total gestational weight gain as well as records of antenatal care were extracted using electronic medical records, and antenatal weight gain measurements were standardized into gestational age-specific z scores. RESULTS Among these 15,541 multiparous women, 534 (3.44%) developed preeclampsia. The odds of preeclampsia increased by 26% with every 1 z score increase in pregnancy weight gain among normal weight women and by 41% among overweight or obese women. For normal weight women, pregnant women with preeclampsia gained more weight than pregnant women without preeclampsia beginning at 25 weeks of gestation, while accelerated weight gain was more obvious in overweight or obese women after 25 weeks of gestation. CONCLUSIONS In conclusion, excessive GWG in normal weight and overweight or obese multiparas was strongly associated with the increased risk of preeclampsia. In parallel, the appropriate management and control of weight gain, especially in the second and third trimesters, may lower the risk of developing preeclampsia.
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Affiliation(s)
- Chao Chen
- Department of obstetrics, School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, 200030, China
- Shanghai Key Laboratory of Embryo Original Disease, Shanghai, 200030, China
| | - Zhijun Lei
- Department of Cardiology, School of Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, China
| | - Yaoxi Xiong
- Department of obstetrics, School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, 200030, China
- Shanghai Key Laboratory of Embryo Original Disease, Shanghai, 200030, China
| | - Meng Ni
- Department of obstetrics, School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, 200030, China
- Shanghai Key Laboratory of Embryo Original Disease, Shanghai, 200030, China
| | - Biwei He
- Department of obstetrics, School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Jing Gao
- Department of obstetrics, School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Panchan Zheng
- Department of obstetrics, School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Xianjing Xie
- Department of obstetrics, School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Chengrong He
- Department of obstetrics, School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, 200030, China
- Shanghai Key Laboratory of Embryo Original Disease, Shanghai, 200030, China
| | - Xingyu Yang
- Department of obstetrics, School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, 200030, China.
- Shanghai Key Laboratory of Embryo Original Disease, Shanghai, 200030, China.
| | - Weiwei Cheng
- Department of obstetrics, School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, 200030, China.
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