Impact of experiencing multiple vulnerabilities on fetal growth and complications in women with hyperglycemia in pregnancy.
Food insecurity
Hyperglycemia in pregnancy
Language proficiency
Large-for-gestational-age infant
Psychosocial deprivation
Small-for-gestational-age infant
Journal
BMC pregnancy and childbirth
ISSN: 1471-2393
Titre abrégé: BMC Pregnancy Childbirth
Pays: England
ID NLM: 100967799
Informations de publication
Date de publication:
18 Oct 2023
18 Oct 2023
Historique:
received:
26
09
2022
accepted:
03
10
2023
medline:
23
10
2023
pubmed:
19
10
2023
entrez:
18
10
2023
Statut:
epublish
Résumé
In women with hyperglycemia in pregnancy living in France, psychosocial deprivation is associated with both earlier and greater exposure to the condition, as well as poorer maternofetal prognosis. We explored the impact of this and two other socioeconomic vulnerability indicators-food insecurity and poor language proficiency-on adherence to prenatal care and maternal and fetal outcomes. In a socially deprived suburb of Paris, we selected women who delivered between 01/01/2012 and 31/12/2018 and received care (nurse, dietician, diabetologist evaluation, advice, regular follow-up to adjust insulin doses if requested) for hyperglycemia in pregnancy. We analyzed the associations between individual psychosocial deprivation, food insecurity, French language proficiency (variables assessed by individual questionnaires) and fetal growth (main outcome), as well as other core maternal and fetal outcomes. Among the 1,168 women included (multiethnic cohort, 19.3% of whom were Europeans), 56%, 17.9%, and 27.5% had psychosocial deprivation, food insecurity, and poor French language proficiency, respectively. Forty-three percent were prescribed insulin therapy. Women with more than one vulnerability had more consultations for diabetes. The rates for small (SGA), appropriate (AGA), and large-for-gestational-age (LGA) infant were 11.4%, 76.5% and 12.2%, respectively. These rates were similar in women with and without psychosocial deprivation, and in those with and without food insecurity. Interestingly, women with poor French language proficiency had a higher odds ratio of delivering a small- or large-for-gestational age infant than those with good proficiency. We found similar pregnancy outcomes for women with hyperglycemia in pregnancy living in France, irrespective of whether or not they had psychosocial deprivation or food insecurity. Optimized single-center care with specialized follow-up could contribute to reduce inequalities in maternal and fetal outcomes in women with hyperglycemia in pregnancy.
Sections du résumé
BACKGROUND
BACKGROUND
In women with hyperglycemia in pregnancy living in France, psychosocial deprivation is associated with both earlier and greater exposure to the condition, as well as poorer maternofetal prognosis. We explored the impact of this and two other socioeconomic vulnerability indicators-food insecurity and poor language proficiency-on adherence to prenatal care and maternal and fetal outcomes.
METHODS
METHODS
In a socially deprived suburb of Paris, we selected women who delivered between 01/01/2012 and 31/12/2018 and received care (nurse, dietician, diabetologist evaluation, advice, regular follow-up to adjust insulin doses if requested) for hyperglycemia in pregnancy. We analyzed the associations between individual psychosocial deprivation, food insecurity, French language proficiency (variables assessed by individual questionnaires) and fetal growth (main outcome), as well as other core maternal and fetal outcomes.
RESULTS
RESULTS
Among the 1,168 women included (multiethnic cohort, 19.3% of whom were Europeans), 56%, 17.9%, and 27.5% had psychosocial deprivation, food insecurity, and poor French language proficiency, respectively. Forty-three percent were prescribed insulin therapy. Women with more than one vulnerability had more consultations for diabetes. The rates for small (SGA), appropriate (AGA), and large-for-gestational-age (LGA) infant were 11.4%, 76.5% and 12.2%, respectively. These rates were similar in women with and without psychosocial deprivation, and in those with and without food insecurity. Interestingly, women with poor French language proficiency had a higher odds ratio of delivering a small- or large-for-gestational age infant than those with good proficiency.
CONCLUSION
CONCLUSIONS
We found similar pregnancy outcomes for women with hyperglycemia in pregnancy living in France, irrespective of whether or not they had psychosocial deprivation or food insecurity. Optimized single-center care with specialized follow-up could contribute to reduce inequalities in maternal and fetal outcomes in women with hyperglycemia in pregnancy.
Identifiants
pubmed: 37853313
doi: 10.1186/s12884-023-06048-9
pii: 10.1186/s12884-023-06048-9
pmc: PMC10585815
doi:
Substances chimiques
Insulins
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
740Informations de copyright
© 2023. BioMed Central Ltd., part of Springer Nature.
Références
BMC Pregnancy Childbirth. 2014 Mar 04;14:96
pubmed: 24589212
Hypertens Pregnancy. 2021 May;40(2):109-117
pubmed: 33476216
Diabet Med. 2019 Feb;36(2):214-220
pubmed: 30307050
BMC Pregnancy Childbirth. 2018 Dec 11;18(1):486
pubmed: 30537936
J Perinatol. 2006 Jun;26(6):328-32
pubmed: 16642026
J Hum Nutr Diet. 2021 Oct;34(5):849-857
pubmed: 33730420
Diabetes Care. 2010 Mar;33(3):676-82
pubmed: 20190296
Rev Fr Gynecol Obstet. 1971 Jun-Jul;66(6):391-6
pubmed: 5112836
Int J Mol Sci. 2021 Sep 19;22(18):
pubmed: 34576285
Diabetes Metab. 2010 Dec;36(6 Pt 2):695-9
pubmed: 21163431
Diabetes Res Clin Pract. 2022 Jan;183:109050
pubmed: 34883186
BMJ Open. 2020 Feb 2;10(1):e033296
pubmed: 32014876
Diabetes Metab. 2010 Dec;36(6 Pt 2):617-27
pubmed: 21163425
Diabetes Metab. 2015 Nov;41(5):387-92
pubmed: 25636580
Healthc Manage Forum. 2017 Jul;30(4):207-212
pubmed: 28929878
Placenta. 2019 Oct;86:28-34
pubmed: 31401007
BMJ Open. 2015 Mar 06;5(3):e007120
pubmed: 25748416
Public Health Nutr. 2002 Dec;5(6A):859-64
pubmed: 12633509
JAMA. 2017 Jun 06;317(21):2207-2225
pubmed: 28586887
Health Place. 2014 Nov;30:98-106
pubmed: 25240489
Soc Sci Med. 2020 Jan;245:112683
pubmed: 31760320
Diabetes Metab. 2022 Sep;48(5):101376
pubmed: 35907622
J Am Diet Assoc. 2010 May;110(5):692-701
pubmed: 20430130
Diabetologia. 2020 Jun;63(6):1120-1127
pubmed: 32193573
BMC Pregnancy Childbirth. 2019 Jul 3;19(1):223
pubmed: 31269913
Am J Perinatol. 2015 Feb;32(3):239-46
pubmed: 24971568
JAMA. 2022 Apr 12;327(14):1356-1367
pubmed: 35412565
J Diabetes Investig. 2020 Jul;11(4):994-1001
pubmed: 32012487
J Obstet Gynecol Neonatal Nurs. 2005 Jul-Aug;34(4):512-20
pubmed: 16020421
BMC Pregnancy Childbirth. 2017 May 16;17(1):126
pubmed: 28506217
Sante Publique. 2006 Dec;18(4):513-22
pubmed: 17294755
World J Pediatr. 2019 Oct;15(5):483-491
pubmed: 31286424
J Diabetes Investig. 2017 Mar;8(2):161-167
pubmed: 27397133
EClinicalMedicine. 2021 Dec 13;43:101237
pubmed: 34977514
Women Health. 2016;56(3):257-80
pubmed: 26361937
Lancet. 2021 Nov 20;398(10314):1905-1912
pubmed: 34735797
Diabetes Metab. 2010 Dec;36(6 Pt 2):522-37
pubmed: 21163418
J Obstet Gynaecol Can. 2005 Jan;27(1):51-3
pubmed: 15937583
Nutrients. 2021 Apr 09;13(4):
pubmed: 33918747
Diabetes Care. 2005 Nov;28(11):2680-5
pubmed: 16249539