Gestational Diabetes, Obesity, and Metabolic Syndrome Diagnosed During Pregnancy

Background: The aim was to analyze the impact of obesity on women with gestational diabetes mellitus (GDM) and the association of obesity and GDM with the metabolic syndrome. Methods: In a retrospective study, the data of 233 obese women with GDM were compared with the data of 96 women with GDM and normal weight. Results: Significantly higher fasting glycemia before the oral glucose tolerance test (5.2 +/- 1.1 mmol/L vs. 4.5 +/- 0.8 mmol/L, P < 0.00001) and higher frequency of hypertensive disorders of pregnancy (26.2% vs. 9.4%, P = 0.0003) were found in obese women with GDM than in GDM women of normal weight. These women needed insulin therapy more often (18.9% vs. 8.3%, P = 0.007). Also 31 (13.3 %) of them had chronic hypertension as compared with 3.1% in women of normal weight (P = 0.003). These 31 women had three components necessary for diagnosing of metabolic syndrome according to the World Health Organization-impaired glucose tolerance, obesity, and hypertension. No difference in gestational age and mean weight of their newborns was found, but newborns of obese GDM women with metabolic syndrome components more often were significantly macrosomic with features of diabetic fetopathy and had more often symptoms of hypoglycemia after birth. Conclusions: The presence of obesity and GDM has a significant impact on both maternal and fetal complications. The metabolic syndrome can be diagnosed not only after pregnancy but also during pregnancy.