Maternal BMI at the time of birth and selected risk factors associated with severe neonatal outcomes: a secondary analysis of the WHO Better Outcomes in Labour Difficulty (BOLD) project.

The main objective of this secondary analysis was to describe the nutritional status of the Better Outcomes in Labour Difficulty (BOLD) project study population and determine possible associations between maternal nutritional status (as reflected by maternal BMI at the time of birth) and severe neonatal outcomes (SNO). We also analysed previous and index maternal pathologies to determine associations with neonatal outcomes. We used the classification designed by Atalah for maternal BMI and compared with the Hyperglycaemia and Adverse Pregnancy Outcome study one. To describe the nutritional status of this population, figures of distribution and test of normality related to weight and BMI were presented for the women and their babies. To explore the association between maternal BMI data and SNO, the χ2 test was performed. To identify a maternal characteristic or a group of characteristics that could predict SNO, we used Fisher's exact test using previous maternal pathology collected in the BOLD project as well as that in the index pregnancy. In this study, BMI at the time of birth was not associated with neonatal near miss or death. We found that previous maternal obesity, diabetes and chronic hypertension were associated with SNO. Maternal pathology in the index pregnancy such as other obstetric haemorrhage, pre-eclampsia, anaemia and gestational diabetes was associated with SNO.

Accuracy of 50-g glucose challenge test to detect International Association of Diabetes and Pregnancy Study Groups criteria-defined hyperglycemia.

OBJECTIVES: To determine the accuracy of the 50-g glucose challenge test (GCT) in detecting hyperglycemia in pregnancy (HIP) across a range of glucose thresholds relative to the International Association of Diabetes and Pregnancy Study Groups diagnostic criteria, and to determine the accuracy of the 50-g GCT among patients with different risk status. METHODS: The present prospective cohort study included women aged 18-45 years at 24-31+6  weeks of pregnancy who presented at the Mother and Child Hospital, Akure, Nigeria, between September 1, 2015, and February 29, 2016. Patients underwent the 50-g GCT followed by the 75-g oral glucose tolerance test (OGTT). The accuracy of different 50-g GCT thresholds in diagnosing HIP was assessed based on International Association of Diabetes and Pregnancy Study Groups diagnostic criteria, with the 75-g OGTT used as a clinical reference standard. RESULTS: Of 280 patients enrolled, 46 (16.4%) had HIP. The sensitivity of the 50-g GCT to detect HIP decreased from 47.8% (95% confidence interval [CI], 32.9-63.1) at a 7.2-mmol/L threshold to 32.6% (95% CI, 19.5-48.0) at a 8.0-mmol/L threshold; the specificity improved from 84.2% (95% CI, 78.9-88.6) to 95.3% (95% CI, 91.7-97.6), respectively. CONCLUSION: The 50-g GCT performed poorly compared with the 75-g OGTT for detecting HIP. It appears to be an unsuitable replacement for the 75-g OGTT.