Neck circumference as a predictor of gestational diabetes and risk of adverse outcomes in pregnancy of Brazilian woman with overweight and obesity.

OBJECTIVE

To evaluate the association of neck circumference (NC) with gestational diabetes (GDM) and adverse outcomes in women with overweight and obesity.

SUBJECTS AND METHODS

This prospective study included 132 (BMI > 25 kg/m) pregnant women without and with GDM. Standardized questionnaire and biochemical/physical evaluation were performed during the 1 to 3 trimester. Fifth-five women were evaluated regarding hypertension in pregnancy, type of delivery and neonatal complications (death, intensive care unit admission and hypoglycemia).

RESULTS

Women with (n = 61) and without (n = 71) GDM had similar mean (SD) pre-gestational BMI [30.3 (4.0) 29.4 (3.5) kg/m, p = 0.16]. Women with GDM were older [32 (6) 28 (6) yrs, p < 0.001] and had greater NC [36.0 (2.7) 34.5 (1.8) cm, p < 0.001]. NC was similar in women with GDM diagnosed in first or third trimester [p = 0.4] and was correlated with FPG [r 0.29, p = 0.01] and systolic [r 0.28, p = 0.001] and diastolic [r 0.25, p = 0.004] blood pressure. NC was associated with GDM [OR 1.25, 95%CI 1.03-1.52] adjusted for age, physical activity, education and familiar history of diabetes. In ROC analysis, the area under the curve was 0.655 and the cut-off value of 34.5 cm had 0.70 of sensitivity and 0.51 of specificity for GDM. Women who had NC ≥ 34.5 < 34.5 cm had higher frequencies of hypertension [32.3 4.2%, p = 0.01].

CONCLUSION

In a group of pregnant women with overweight or obesity, NC can be a useful tool for identifying risk of GDM and obstetric adverse outcomes.