Associations of morbid obesity with late diagnosis of gestational diabetes, and with related obstetrical and neonatal outcomes

Abstract Objective: To investigate associations of maternal obesity with late GDM diagnosis (>34 weeks) and related obstetrical and neonatal outcomes.Study Design: This was a retrospective cohort study of 238 women who underwent late oral glucose tolerance tests (OGTT) (>34 weeks) for suspected macrosomia or polyhydramnios. Obstetrical and perinatal outcomes were stratified by GDM and morbid obesity (BMI>35 kg/m2) status. Obstetrical complications included pre-eclampsia, induction of labor, cesarean delivery, shoulder dystocia, and third or fourth-degree perineal tear. Neonatal outcomes included Apgar score, arterial cord pH, neonatal hypoglycemia, jaundice, the need for phototherapy, and polycythemia. Results: Late GDM rate was 22.2% and increased the risk for macrosomia, large-for-gestational-age fetus, induction of labor; and neonatal hypoglycemia, jaundice, and need for phototherapy. Conclusion: Adverse pregnancy outcomes are related to morbid obesity in women with late GDM; this population requires special surveillance. Repeat GDM screening beyond 34 weeks should be considered.