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Garmendia, M. L., Mondschein, S., Montiel, B., & Kusanovic, J. P. (2020). Trend and predictors of gestational diabetes mellitus in Chile. Int. J. Gynecol. Obstet., 148(2), 210–218.
To examine the temporal trends in gestational diabetes mellitus (GDM) prevalence in Chile, and to determine the main predictors of GDM.
A secondary analysis was conducted of all birth records at Hospital Dr. Sótero del Río, Chile, from January 1, 2002, to December 31, 2015. We excluded those women with pre‐existing type 2 diabetes, those with missing data, and those with unlikely data. GDM was defined as fasting glucose levels >5.55 mmol/L [>100 mg/dL] or >7.77 mmol/L [>140 mg/dL] 2 hours after glucose load in the oral glucose tolerance test. Potential predictors were selected based on prior research and ease of evaluation.
From the original database of 100 758 records, 86 362 women were included in the final cohort. The mean GDM prevalence was 7.6% (95% CI [confidence interval] 7.5%�7.8%), increasing from 4.4% (95% CI 4.0%�4.9%) in 2002 to 13.0% (95% CI 12.0%�13.9%) in 2015. Age, education, marital status, parity, family history of type 2 diabetes, personal history of GDM, hypertension and pre‐eclampsia, alcohol consumption, smoking, and pre‐gestational nutritional status performed well in the prediction of GDM.
One out of eight Chilean pregnant women of medium‐ to low socio‐economic status were found to develop GDM. We identified a set of easy‐to‐capture predictors in the primary health care system that may allow for the early identification of women at high‐risk for the development of GDM.
Garmendia, M. L., Mondschein, S., Montiel, B., & Kusanovic, J. P. (2021). Trends and predictors of birth weight in Chilean children. Public Health, 193, 61–68.
Abstract: Objectives: Birth weight is an important public health indicator that reflects fetal health conditions and predicts future health. Identifying the most important factors related to birth weight would help defining preventive health strategies for both mothers and children. The objectives of this study are i. to describe, using a large birth database from a Chilean hospital, the trend of birth weight during 2002-2015, and ii. to determine factors during prenatal care associated with low and high birth weight.
Study design: This study is a secondary analysis of all single birth records at a Chilean Hospital in the southeast district of Santiago, Chile, during 2002-2015 (N = 78,931).
Methods: Sociodemographic information, clinical and obstetric history, lifestyle, and anthropometric variables were evaluated as potential predictors. Birth weight was categorized into five groups as per percentiles of weight as per gestational age. Data were extracted from clinical records. We used classification and regression tree methodology and logistic regression.
Results: The average birth weight for the period was 3316 g (SD 566), with little variation across time. Preterm births increased from 7% in 2002 to 10% in 2015, and births >40 weeks decreased from 10.7% in 2002 to 4.4% in 2015. The percentages of small and large for gestational age changed from 10.9% and 12.7% in 2002 to 9.9% and 13.9% in 2015, respectively. The predictors included in the optimal tree were body mass index, gestational weight gain, pre-eclampsia, and gestational diabetes. We found that women with a pregestational body mass index <28 kg/m(2), gestational weight gain <17 kg, and pre-eclampsia had a probability of 41% of having a small for gestational age neonate. Conversely, women with a body mass index similar to 28 kg/m(2), gestational weight gain similar to 17 kg, and gestational diabetes had a probability of 44% of having a large for gestational age neonate.
Conclusions: This study showed that the most important variables explaining birth weight are those related to maternal nutritional status. Thus, the strategies to promote a normal birth weight should aim for a normal maternal weight at the beginning of pregnancy, gestational weight gain within the recommendations, and prevention of gestational diabetes and pre-eclampsia. (C) 2021 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Keywords: PREPREGNANCY WEIGHT; PREGNANCY; CONSEQUENCES; PREECLAMPSIA; HYPERTENSION; ASSOCIATION; VALIDITY; HISTORY; DISEASE; PARITY