alison nankervis

Impact of preconception weight loss on fasting glucose and pregnancy outcomes in women with obesity: A randomized trial

Publisher: Wiley

Date: 24-08-2021

DOI: 10.1002/OBY.23200

Abstract: This study examined the effectiveness of a nonsurgical, preconception weight loss intervention on pregnancy outcomes in women with obesity. This was a two‐arm, parallel‐group randomized controlled trial. A total of 164 women with BMI 30 to 55 kg/m 2 who were aged 18 to 38 years and planning pregnancy were randomized to a 12‐week standard dietary intervention (SDI n = 79) or a modified very low‐energy diet (VLED n = 85). Participants were observed for ≤48 weeks while trying for pregnancy and then during pregnancy. The primary outcome was maternal fasting plasma glucose at 26 to 28 weeks’ gestation. Exploratory outcomes were in idual and composite obesity‐related adverse pregnancy outcomes. Weight loss was greater in the VLED group (SDI 3.2 [0.6] kg vs. VLED 13.0 [0.5] kg, p 0.01). In completers who had a singleton live birth (SDI 22/79 vs. VLED 35/85, p = 0.10), there was no difference in fasting glucose at 26 to 28 weeks’ gestation (SDI 4.8[0.2] mmol/L vs. VLED 4.6 [0.1] mmol/L, p = 0.42). However, the composite of adverse pregnancy outcomes was significantly lower in the VLED group ( p 0.001). Substantial prepregnancy weight loss in women with obesity does not alter fasting glucose at 26 to 28 weeks’ gestation but does reduce a composite of adverse pregnancy outcomes. A better understanding of metabolic changes in pregnancy after preconception weight loss may assist in improving maternal and neonatal health outcomes.

Optimising the implementation of guidelines for the post partum testing and management of gestational diabetes in South Asian women in Australia

Publisher: AMPCo

Date: 11-06-2020

DOI: 10.5694/MJA2.50660

Women with type 1 diabetes and women with type 2 diabetes differ in knowledge and beliefs about contraception and pregnancy

Publisher: Wiley

Date: 02-02-2021

DOI: 10.1111/DME.14521

Abstract: To assess differences in knowledge and beliefs about pregnancy in women with diabetes. Questions were from the Australian ‘ Contraception, Pregnancy & Women's Health’ survey. Women (18–50 years) were eligible if pregnant or planning pregnancy. Knowledge and beliefs items were adapted from the Reproductive Health and Behaviours Questionnaire. Compared to women with type 2 diabetes ( n = 103), women with type 1 diabetes ( n = 526) had higher scores for knowledge about pregnancy in diabetes (type 1 diabetes 9.8 ± 2.4 vs. type 2 diabetes 7.7 ± 3.1), beliefs about benefits (type 1 diabetes 18.4 ± 2.2 vs. type 2 diabetes 17.2 ± 3.3), cues‐to‐action (type 1 diabetes 2.7 ± 1.4 vs. type 2 diabetes 1.5 ± 1.3) and self‐efficacy (type 1 diabetes 22.6 ± 5.5 vs. type 2 diabetes 20.2 ± 6.1 (all p 0.001) regarding preparing for pregnancy. Major knowledge gaps were the need for higher dose folate compared to women without diabetes and uncertainty about breastfeeding recommendations. Women with type 1 diabetes believed more strongly in the benefits of ‘close to target’ glucose levels prior to pregnancy and using contraception to prevent unplanned pregnancy they also felt more confident to access pre‐pregnancy care and to wait for optimal glycaemia before pregnancy. Women with type 2 diabetes were less aware of contraceptive choices, and risks associated with hyperglycaemia before or early in pregnancy. The findings highlighted main gaps in knowledge and beliefs about planning for pregnancy. Especially in type 2 diabetes, there is a need for evidence‐based messaging and strategies addressing these gaps, to raise understanding to prepare for future pregnancies.

Royal Women's Hospital

Location: Australia

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Royal Melbourne Hospital

Location: Australia

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Royal Australasian College Of Physicians

Location: Australia

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University Of Melbourne

Location: Australia

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