oru.sePublications
Change search
Link to record
Permanent link

Direct link
BETA
Hanson, Ulf
Alternative names
Publications (10 of 16) Show all publications
Rönnberg, A.-K., Hanson, U. & Nilsson, K. (2017). Effects of an antenatal lifestyle intervention on offspring obesity: a 5-year follow-up of a randomized controlled trial. Acta Obstetricia et Gynecologica Scandinavica, 96(9), 1093-1099
Open this publication in new window or tab >>Effects of an antenatal lifestyle intervention on offspring obesity: a 5-year follow-up of a randomized controlled trial
2017 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 96, no 9, p. 1093-1099Article in journal (Refereed) Published
Abstract [en]

Introduction: Strategies to limit excessive maternal gestational weight gain could also have positive health effects for the offspring. This study informs us on the effect of an antenatal lifestyle intervention on offspring body mass index (BMI) trajectory until age five.

Material and methods: A secondary analysis of a randomized controlled trial aimed at reducing gestational weight gain, set in Orebro, Sweden (Clinical Trials.gov Id NCT00451425). Offspring were followed with standardized measures of weight and height until age five. Mean BMI z-score and proportion (%) of over- and undernutrition (BMI z-score > 2 standard deviations) was compared between groups. Risk estimates for obesity at age five were analyzed in relation to maternal gestational weight gain and prepregnancy BMI as a secondary outcome.

Results: We analyzed 374 children at birth and 300 at age five. No significant difference in mean BMI z-score was seen at birth (0.68 (I) vs 0.56 (C), p = 0.242) or at age five (0.34 (I) vs 0.26 (C), p = 0.510) and no significant difference in proportion of over- or undernutrition was seen. Excessive maternal gestational weight gain was an independent risk factor for offspring obesity at birth (OR = 4.51, p < 0.001) but not at age five. Maternal obesity was an independent risk factor for offspring obesity at age five (OR = 4.81, p = 0.006).

Conclusions: Our composite antenatal lifestyle intervention did not significantly reduce the risk of obesity in offspring up until age five.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
Keywords
Exercise, midwifery, obesity, pregnancy, prenatal care
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:oru:diva-60594 (URN)10.1111/aogs.13168 (DOI)000407745700009 ()2-s2.0-85020964495 (Scopus ID)
Note

Funding Agency:

Research Committee at Örebro County Council

Available from: 2017-09-05 Created: 2017-09-05 Last updated: 2018-08-05Bibliographically approved
Rönnberg, A., Hanson, U., Östlund, I. & Nilsson, K. (2016). Effects on postpartum weight retention after antenatal lifestyle intervention: a secondary analysis of a randomized controlled trial. Acta Obstetricia et Gynecologica Scandinavica, 95(9), 999-1007
Open this publication in new window or tab >>Effects on postpartum weight retention after antenatal lifestyle intervention: a secondary analysis of a randomized controlled trial
2016 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 95, no 9, p. 999-1007Article in journal (Refereed) Published
Abstract [en]

Introduction: High weight retention after pregnancy is related to an increased risk of future obesity. The objective was to evaluate if an antenatal intervention, compared to standard care, could reduce postpartum weight retention (PPWR).

Material and methods: Women with body mass index >19, age ≥18 years, knowledge of Swedish, and pregnancy ≤16 weeks' gestation were randomized. Standard care was compared to a composite intervention including a personalized weight graph, education on recommended weight gain, prescription of exercise, and monitoring of weight until one year after delivery. Mean (kg) PPWR was compared between the groups and risk estimates (odds ratio) for excessive weight retention were calculated.

Results: Of 445 women randomized, 267 remained for analysis at ≤16 weeks postpartum and 168 at one year postpartum. The intervention group had a significantly lower mean PPWR at ≤16 weeks (1.81 kg (standard deviation, SD, 4.52) vs. 3.19 kg (SD 4.77), p=0.016). At one year postpartum, mean retention was still 0.7 kg lower in the intervention group (0.30 kg (SD 5.52) vs. 1.00 kg (SD 5.46)), the difference was not statistically significant (p=0.414). Gestational weight gain above Institute of Medicine recommendations was a significant risk factor for excessive weight retention (>5 kg) one year after delivery (OR 2.44; 95% CI; 1.08-5.52, p=0.029).

Conclusions: A composite lifestyle intervention during pregnancy reduced short-term weight retention, but the effect of the intervention did not remain at one year postpartum. A gestational weight gain above Institute of Medicine recommendations increases the risk of excessive long-term weight retention.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2016
Keywords
Prenatal care, obesity, women´s health issues, pregnancy
National Category
Obstetrics, Gynecology and Reproductive Medicine Nutrition and Dietetics
Identifiers
urn:nbn:se:oru:diva-49940 (URN)10.1111/aogs.12910 (DOI)000386782100007 ()27100375 (PubMedID)2-s2.0-84982221108 (Scopus ID)
Note

Funding Agency:

Research Committee at Orebro County Council

Available from: 2016-04-26 Created: 2016-04-26 Last updated: 2018-07-10Bibliographically approved
Hildén, K., Hanson, U., Persson, M. & Fadl, H. (2016). Overweight and obesity: a remaining problem in women treated for severe gestational diabetes. Diabetic Medicine, 33(8), 1045-1051
Open this publication in new window or tab >>Overweight and obesity: a remaining problem in women treated for severe gestational diabetes
2016 (English)In: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 33, no 8, p. 1045-1051Article in journal (Refereed) Published
Abstract [en]

Aim: To analyse the impact of overweight and obesity on the risk of adverse maternal outcomes and fetal macrosomia in pregnancies of women treated for severe gestational diabetes.

Methods This was a population-based cohort study including all singleton pregnancies in Sweden without pre-existing diabetes in the period 1998-2012. Only mothers with an early- pregnancy BMI of ≥18.5 kg/m² were included. Logistic regression analysis was used to determine odds ratios with 95% CIs for maternal outcomes and fetal growth. Analyses were stratified by maternal gestational diabetes/non-gestational diabetes to investigate the impact of overweight/obesity in each group.

Results: Of 1 249 908 singleton births, 13 057 were diagnosed with gestational diabetes (1.0%). Overweight/obesity had the same impact on the risks of caesarean section and fetal macrosomia in pregnancies with and without gestational diabetes, but the impact of maternal BMI on the risk of preeclampsia was less pronounced in women with gestational diabetes. Normal-weight women with gestational diabetes had an increased risk of caesarean section [odds ratio 1.26 (95% CI 1.16-1.37)], preeclampsia [odds ratio 2.03 (95% CI 1.71-2.41)] and large-for-gestational-age infants [odds ratio 2.25 (95% CI 2.06-2.46)]. Risks were similar in the overweight group without gestational diabetes, caesarean section [odds ratio 1.34 (1.33-1.36)], preeclampsia odds ratio [1.76 (95% CI 1.72-1.81)], large-for-gestational-age [odds ratio 1.76 (95% CI 1.74-1.79)].

Conclusions: Maternal overweight and obesity is associated with similar increments in risks of adverse maternal outcomes and delivery of large-for-gestational-age infants in women with and without gestational diabetes. Obese women with gestational diabetes are defined as a high-risk group. Normal-weight women with gestational diabetes have similar risks of adverse outcomes to overweight women without gestational diabetes.

Place, publisher, year, edition, pages
Hoboken, USA: Wiley-Blackwell Publishing Inc., 2016
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:oru:diva-50308 (URN)10.1111/dme.13156 (DOI)000379936000005 ()27172974 (PubMedID)2-s2.0-84978818273 (Scopus ID)
Note

Funding Agency:

Research Committee of Örebro County Council

Available from: 2016-05-27 Created: 2016-05-16 Last updated: 2018-11-19Bibliographically approved
Fadl, H. E., Gärdefors, S., Hjertberg, R., Nord, E., Persson, B., Schwarcz, E., . . . Hanson, U. S. B. (2015). Randomized controlled study in pregnancy on treatment of marked hyperglycemia that is short of overt diabetes. Acta Obstetricia et Gynecologica Scandinavica, 94(11), 1181-1187
Open this publication in new window or tab >>Randomized controlled study in pregnancy on treatment of marked hyperglycemia that is short of overt diabetes
Show others...
2015 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 94, no 11, p. 1181-1187Article in journal (Refereed) Published
Abstract [en]

Introduction: A randomized multicenter study was conducted in the Stockholm-orebro areas in Sweden to evaluate how treatment aiming at normoglycemia affects fetal growth, pregnancy and neonatal outcome in pregnant women with severe hyperglycemia.

Material and methods: Pregnant women with hyperglycemia defined as fasting capillary plasma glucose <7.0 mmol/L and a two-hour plasma glucose value 10.0 and <12.2 mmol/L following a 75-g oral glucose tolerance test (OGTT) diagnosed before 34 weeks of gestation were randomized to treatment (n=33) or controls (n=36). Women assigned to the control group were blinded for the OGTT results and received routine care. The therapeutic goal was fasting plasma glucose 4-5 mmol/L, and <6.5 mmol/L after a meal. Primary outcomes were size at birth and number of large-for-gestational age (>90th percentile) neonates. Secondary outcomes were pregnancy complications, neonatal morbidity and glycemic control.

Results: The planned number of participating women was not reached. There was a significantly reduced rate of large-for-gestational age neonates, 21 vs. 47%, P<0.05. Group differences in pregnancy complications and neonatal morbidity were not detected because of limited statistical power. In total, 66.7% of the women in the intervention group received insulin. Of all measured plasma glucose values, 64.1% were in the target range, 7.2% in the hypoglycemic range and 28.7% above target values. There were no cases of severe hypoglycemia.

Conclusions: Aiming for normalized glycemia in a pregnancy complicated by severe hyperglycemia reduces fetal growth but is associated with an increased rate of mild hypoglycemia.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2015
Keywords
Pregnancy, gestational diabetes mellitus, hyperglycemia, treatment, birthweight, compliance, large-for-gestational age
National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Obstetrics and Gynaecology
Identifiers
urn:nbn:se:oru:diva-46438 (URN)10.1111/aogs.12717 (DOI)000362844400006 ()26222270 (PubMedID)2-s2.0-84943587292 (Scopus ID)
Funder
Swedish Diabetes Association
Note

Funding Agencies:

Uppsala-Örebro Regional Research Council

Praktikertjänst AB, Stockholm, Sweden

Available from: 2015-11-10 Created: 2015-11-10 Last updated: 2018-04-16Bibliographically approved
Fadl, H., Magnuson, A., Östlund, I., Montgomery, S., Hanson, U. & Schwarcz, E. (2014). Gestational diabetes mellitus and later cardiovascular disease: a Swedish population based case-control study. British Journal of Obstetrics and Gynecology, 121(12), 1530-1536
Open this publication in new window or tab >>Gestational diabetes mellitus and later cardiovascular disease: a Swedish population based case-control study
Show others...
2014 (English)In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 121, no 12, p. 1530-1536Article in journal (Refereed) Published
Abstract [en]

Objective: To identify if gestational diabetes mellitus (GDM) is a clinically useful marker of future cardiovascular disease (CVD) risk and if GDM combined with other risks (smoking, hypertension or body mass) identifies high-risk groups.

Design: Population-based matched case-control study.

Setting: National Swedish register data from 1991 to 2008.

Population: A total of 2639 women with a cardiovascular event and matched controls.

Methods: Conditional logistic regression examined associations with CVD before and after adjustment for conventional risk factors and confounders. Effect modification for the association of GDM with CVD by body mass index (BMI), smoking and chronic hypertension was assessed by stratification and interaction testing. Adjustment for diabetes post-pregnancy evaluated its mediating role.

Main outcome measures: Inpatient diagnoses or causes of death identifying ischemic heart disease, ischemic stroke, atherosclerosis or peripheral vascular disease.

Results: The adjusted odds ratios (and 95% confidence intervals) for the association of CVD with GDM are 1.51 (1.07-2.14), 2.23 (2.01-2.48) for smoking, 1.98 (1.71-2.29) for obesity and 5.10 (3.18-8.18) for chronic hypertension. In stratified analysis the association of CVD with GDM was only seen among women with BMI 25, with an odds ratio of 2.39 (1.39-4.10), but only women with a BMI <30 accounted for this increased risk. Adjustment for post-pregnancy diabetes attenuated it somewhat to 1.99 (1.13-3.52).

Conclusions: In the absence of other recognised cardiovascular risk factors, such as smoking, obesity or chronic hypertension, GDM is a useful marker of raised CVD risk among women with BMI between 25 and 29.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2014
Keywords
Body mass index, cardiovascular disease, gestational diabetes mellitus
National Category
Endocrinology and Diabetes Obstetrics, Gynecology and Reproductive Medicine
Research subject
Obstetrics and Gynaecology
Identifiers
urn:nbn:se:oru:diva-39455 (URN)10.1111/1471-0528.12754 (DOI)000344372600013 ()24762194 (PubMedID)2-s2.0-84899041720 (Scopus ID)
Note

Funding Agency:

Research Committee of Örebro County Council, Sweden

Available from: 2014-12-10 Created: 2014-12-10 Last updated: 2018-07-22Bibliographically approved
Jonsson, M., Nordén Lindeberg, S., Östlund, I. & Hanson, U. (2013). Acidemia at birth in the vigorous infant as a trigger incident to assess intrapartum care with regard to CTG patterns. The Journal of Maternal-Fetal & Neonatal Medicine, 26(11), 1094-1098
Open this publication in new window or tab >>Acidemia at birth in the vigorous infant as a trigger incident to assess intrapartum care with regard to CTG patterns
2013 (English)In: The Journal of Maternal-Fetal & Neonatal Medicine, ISSN 1476-7058, E-ISSN 1476-4954, Vol. 26, no 11, p. 1094-1098Article in journal (Refereed) Published
Abstract [en]

Abstract Objective To evaluate if acidemia in vigorous infants is useful in the assessment of intrapartum care with regard to cardiotocographic (CTG) patterns during the second stage. Methods Cases (n=241) were infants with an umbilical artery pH < 7.05, controls (n= 482) were infants with pH ≥ 7.05. Apgar score was ≥ 7 at five minutes in both groups. CTGs during the last two hours of labour were assessed and neonatal outcomes compared. A sub analysis of cases with metabolic acidemia: pH < 7.00 and base deficit ≥ 12mmol/L and, acidemia: 7.00 < pH < 7.05 was performed. Results 63% of cases had a pathological CTG versus 26% of controls (p <0.001). Patterns with severe variable decelerations had a significantly longer duration in cases. Metabolic acidemia was significantly associated with severe variable decelerations and, decreased variability. Infants to cases were admitted to neonatal care in 19 % versus 2 % of controls (p <0.001). With metabolic acidemia, 32 % were admitted. Conclusion An umbilical artery pH < 7.05 at birth of vigorous infants may be a useful variable for quality control of intrapartum management with regard to assessment of second stage CTGs. Differences in duration of pathological patterns indicate passiveness in acidemic cases.

National Category
Surgery
Research subject
Obstetrics and Gynaecology
Identifiers
urn:nbn:se:oru:diva-27154 (URN)10.3109/14767058.2013.770457 (DOI)000320816800009 ()23350711 (PubMedID)
Available from: 2013-01-30 Created: 2013-01-30 Last updated: 2017-12-06Bibliographically approved
Persson, M., Fadl, H., Hanson, U. & Pasupathy, D. (2013). Disproportionate Body Composition and Neonatal Outcome in Offspring of Mothers With and Without Gestational Diabetes Mellitus. Diabetes Care, 36(11), 3543-3548
Open this publication in new window or tab >>Disproportionate Body Composition and Neonatal Outcome in Offspring of Mothers With and Without Gestational Diabetes Mellitus
2013 (English)In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, Vol. 36, no 11, p. 3543-3548Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE High birth weight is a risk factor for neonatal complications. It is not known if the risk differs with body proportionality. The primary aim of this study was to determine the risk of adverse pregnancy outcome in relation to body proportionality in large-for-gestational-age (LGA) infants stratified by maternal gestational diabetes mellitus (GDM).

RESEARCH DESIGN AND METHODSPopulation-based study of all LGA (birth weight [BW] >90th percentile) infants born to women with GDM (n = 1,547) in 1998-2007. The reference group comprised LGA infants (n = 83,493) born to mothers without diabetes. Data were obtained from the Swedish Birth Registry. Infants were categorized as proportionate (P-LGA) if ponderal index (PI) (BW in grams/length in cm(3)) was 90th percentile and as disproportionate (D-LGA) if PI >90th percentile. The primary outcome was a composite morbidity: Apgar score 0-3 at 5 min, birth trauma, respiratory disorders, hypoglycemia, or hyperbilirubinemia. Logistic regression analysis was used to obtain odds ratios (ORs) for adverse outcomes.

RESULTSThe risk of composite neonatal morbidity was increased in GDM pregnancies versus control subjects but comparable between P- and D-LGA in both groups. D-LGA infants born to mothers without diabetes had significantly increased risk of birth trauma (OR 1.19 [95% CI 1.09-1.30]) and hypoglycemia (1.23 [1.11-1.37]). D-LGA infants in both groups had significantly increased odds of Cesarean section.

CONCLUSIONSThe risk of composite neonatal morbidity is significantly increased in GDM offspring. In pregnancies both with and without GDM, the risk of composite neonatal morbidity is comparable between P- and D-LGA.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:oru:diva-32623 (URN)10.2337/dc13-0899 (DOI)000326274100032 ()
Note

Funding Agency: Samariten Foundation; Stockholm City Council; National Institute for Health Research, U.K; Tommy's Charity, U.K.

Available from: 2013-12-04 Created: 2013-12-04 Last updated: 2017-12-06Bibliographically approved
Salmelin, A., Wiklund, I., Bottinga, R., Brorsson, B., Ekman-Ordeberg, G., Grimfors, E. E., . . . Persson, E. (2013). Fetal monitoring with computerized ST analysis during labor: a systematic review and meta-analysis. Acta Obstetricia et Gynecologica Scandinavica, 92(1), 28-39
Open this publication in new window or tab >>Fetal monitoring with computerized ST analysis during labor: a systematic review and meta-analysis
Show others...
2013 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 92, no 1, p. 28-39Article, review/survey (Refereed) Published
Abstract [en]

Background. Computerized ST analysis of fetal electrocardiography (ECG) combined with cardiotochography (CTG) has been introduced for intrapartum monitoring and is the prevailing method when ST analysis (STAN®) is used. Objective. To assess the evidence that computerized ST analysis during labor reduces the incidence of fetal metabolic acidosis, hypoxic ischemic encephalopathy, cesarean section, instrumental vaginal delivery or the number of instances where fetal scalp blood sampling is used as compared with CTG only. Methods. Search of PubMed, Cochrane Library, EMBASE, Web of Science, CINAHL and CRD databases. Selection criteria. CTG only compared with CTG + computerized ST analysis. Data collection and analysis. Studies were assessed using pre-designed templates. Meta-analyses of included randomized controlled trials were performed using a random effects model. Results. Risk ratio for cord metabolic acidosis with STAN® was 0.96 [95% confidence interval (CI) 0.49-1.88]. Risk ratio for cesarean sections or instrumental vaginal deliveries for fetal distress was 0.93 (95%CI 0.80-1.08) and for fetal scalp blood sampling 0.55 (95%CI 0.40-0.76). Encephalopathy cases were not assessed due to their low incidence. Conclusions. There is not enough scientific evidence to conclude that computerized ST analysis reduces the incidence of metabolic acidosis. Cesarean sections and instrumental vaginal deliveries due to fetal distress or other indications are the same, regardless of method, but STAN® reduces the number of instances which require scalp blood sampling.

Place, publisher, year, edition, pages
Hoboken, USA: Wiley-Blackwell, 2013
Keywords
Cardiotochography, fetal electrocardiography, intrapartum monitoring
National Category
Surgery
Research subject
Obstetrics and Gynaecology
Identifiers
urn:nbn:se:oru:diva-27162 (URN)10.1111/aogs.12009 (DOI)000313714500005 ()23210634 (PubMedID)
Available from: 2013-01-30 Created: 2013-01-30 Last updated: 2018-03-06Bibliographically approved
Persson, M., Pasupathy, D., Hanson, U. & Norman, M. (2012). Disproportionate body composition and perinatal outcome in large-for-gestational-age infants to mothers with type 1 diabetes. British Journal of Obstetrics and Gynecology, 119(5), 565-572
Open this publication in new window or tab >>Disproportionate body composition and perinatal outcome in large-for-gestational-age infants to mothers with type 1 diabetes
2012 (English)In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 119, no 5, p. 565-572Article in journal (Refereed) Published
Abstract [en]

Objective: To determine if disproportionate body composition is a risk factor for perinatal complications in large-for-gestational-age infants born to mothers with type 1 diabetes.

Design: Population-based cohort study.

Setting: Data from the Swedish Medical Birth Registry from 1998 to 2007.

Population: National cohort of 3517 infants born to mothers with type 1 diabetes. Only singletons with gestational age 32-43 weeks were included.

Methods: Large for gestational age (LGA) was defined as birthweight > 90th centile and appropriate for gestational age (AGA) as birthweight between 10th and 90th centiles. Disproportionate (D) infants were defined as having a ponderal index [PI: calculated as birthweight in grams/(length in cm)(3) > 90th centile] and proportionate (P) as PI ≤ 90th centile. LGA infants were classified as P-LGA or D-LGA. Odds ratios were calculated for D-LGA and P-LGA infants, with AGA infants as the reference category. Odds ratios were adjusted for mode of delivery, fetal distress and stratified by gestational age.

Main outcome measures: The primary outcome was a composite of neonatal morbidities, i.e. any of the following diagnoses: Apgar score < 7 at 5 minutes, birth trauma (Erb's palsy or clavicle fracture), respiratory disorder, hyperbilirubinaemia or hypoglycaemia requiring treatment.

Results: Composite morbidity was significantly more frequent in LGA as opposed to AGA infants, but there was no difference in risk between P-LGA and D-LGA infants.

Conclusions: High birthweight, irrespective of body proportionality, is a risk factor for neonatal complications in offspring of women with type 1 diabetes.

Place, publisher, year, edition, pages
Hoboken, USA: Wiley-Blackwell, 2012
Keywords
Large-for-date infants, neonatal morbidity, type 1 diabetes
National Category
Surgery
Research subject
Obstetrics and Gynaecology
Identifiers
urn:nbn:se:oru:diva-27160 (URN)10.1111/j.1471-0528.2012.03277.x (DOI)000301340700009 ()22304387 (PubMedID)2-s2.0-84858446785 (Scopus ID)
Available from: 2013-01-30 Created: 2013-01-30 Last updated: 2017-12-06Bibliographically approved
Lagerros, Y. T., Cnattingius, S., Granath, F., Hanson, U. & Wikström, A.-K. (2012). From infancy to pregnancy: birth weight, body mass index, and the risk of gestational diabetes. European Journal of Epidemiology, 27(10), 799-805
Open this publication in new window or tab >>From infancy to pregnancy: birth weight, body mass index, and the risk of gestational diabetes
Show others...
2012 (English)In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 27, no 10, p. 799-805Article in journal (Refereed) Published
Abstract [en]

Obesity is a risk factor for gestational diabetes, whereas the role of the mother's birth weight is more uncertain. We aimed to investigate the combined effect of mothers' birth-weight-for-gestational-age and early pregnancy Body Mass Index (BMI) in relation to risk of gestational diabetes. Between 1973 and 2006, we identified a cohort of 323,083 women included in the Swedish Medical Birth Register both as infants and as mothers. Main exposures were mothers' birth-weight-for-gestational-age (categorized into five groups according to deviation from national mean birth weight) and early pregnancy BMI (classified according to WHO). Rates of gestational diabetes increased with adult BMI, independently of birth-weight-for-gestational-age. However, compared to women with appropriate birth-weight-for-gestational-age [appropriate-for-gestational age (AGA); -1 to +1 SD] and BMI (<25.0), women with obesity class II-III (BMI ≥ 35.0) had an adjusted odds ratio (OR) of 28.7 (95 % confidence interval, CI 17.0-48.6) for gestational diabetes if they were born small-for-gestational-age [small for gestational age (SGA); <-2SD], OR = 20.3 (95 % CI 11.8-34.7) if born large-for-gestational-age [large-for-gestational-age (LGA); >2SD], and OR = 10.4 (95 % CI 8.4-13.0) if born AGA. Risk of gestational diabetes is not only increased among obese women, but also among women born SGA and LGA. Severely obese women born with a low or a high birth-weight-for-gestational-age seem more vulnerable to the development of gestational diabetes compared to normal weight women. Normal pre-pregnancy BMI diminishes the increased risk birth size may confer in terms of gestational diabetes. Therefore, the importance of keeping a healthy weight cannot be overemphasized.

Place, publisher, year, edition, pages
Dordrecht, Netherlands: Springer, 2012
Keywords
Birth weight, epidemiology, gestational diabetes, obesity, pregnancy
National Category
Surgery
Research subject
Obstetrics and Gynaecology; Surgery
Identifiers
urn:nbn:se:oru:diva-27158 (URN)10.1007/s10654-012-9721-7 (DOI)000310891300005 ()22868948 (PubMedID)2-s2.0-84871309727 (Scopus ID)
Available from: 2013-01-30 Created: 2013-01-30 Last updated: 2017-12-06Bibliographically approved
Organisations

Search in DiVA

Show all publications