Quality of life is significantly impaired in long‐term survivors of acute liver failure and particularly in acetaminophen‐overdose patients

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/99595/1/lt23688.pd

Quantifying the Impact of Gestational Diabetes Mellitus, Maternal Weight and Race on Birthweight via Quantile Regression

<div><p>Background</p><p>Quantile regression, a robust semi-parametric approach, was used to examine the impact of gestational diabetes mellitus (GDM) across birthweight quantiles with a focus on maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG).</p><p>Methods</p><p>Using linked birth certificate, inpatient hospital and prenatal claims data we examined live singleton births to non-Hispanic white (NHW, 135,119) and non-Hispanic black (NHB, 76,675) women in South Carolina who delivered 28–44 weeks gestation in 2004–2008.</p><p>Results</p><p>At a maternal BMI of 30 kg/m² at the 90^th quantile of birthweight, exposure to GDM was associated with birthweights 84 grams (95% CI 57, 112) higher in NHW and 132 grams (95% CI: 104, 161) higher in NHB. Results at the 50^th quantile were 34 grams (95% CI: 17, 51) and 78 grams (95% CI: 56, 100), respectively. At a maternal GWG of 13.5 kg at the 90^th quantile of birthweight, exposure to GDM was associated with birthweights 83 grams (95% CI: 57, 109) higher in NHW and 135 grams (95% CI: 103, 167) higher in NHB. Results at the 50^th quantile were 55 grams (95% CI: 40, 71) and 69 grams (95% CI: 46, 92), respectively.</p><p>Summary</p><p>Our findings indicate that GDM, maternal prepregnancy BMI and GWG increase birthweight more in NHW and NHB infants who are already at the greatest risk of macrosomia or being large for gestational age (LGA), that is those at the 90^th rather than the median of the birthweight distribution.</p></div

Characteristics of the study population stratified by race and diabetes status for singleton live births of 28 through 44 weeks gestational age in South Carolina 2004–2008.

<p>Statistics reported are means (sd) or percentages.</p

Predicted Infant Birthweight using model 2.

<p>Results pictured for mother’s age 26, gestational age 38 weeks, prepregnancy BMI 30, averaged over effects of infant sex, prenatal care, smoking, hypertension, first born, and availability of prenatal information at the 50^th (A), 75^th (B), and 90^th (C) quantile.</p

Predicted Infant Birthweight using model 1.

<p>Results pictured for mother’s age 26, gestational age 38 weeks, 11.3 kg (25 lbs) weight gain, averaged over effects of infant sex, prenatal care, smoking, hypertension, first born, and availability of prenatal information at the 50^th (A), 75^th (B), and 90^th (C) quantile.</p

Effect of GDM on Birthweight by Quantile.

<p>Effect of GDM on birthweight in Model One (A) and Model Two (B). The figure presents the additional birthweight associated with a mother having GDM in NHW and NHB for a maternal BMI of 30 or 35 (A) or gestational weight gain of 13.5 or 18 kg (B).</p

Model One: Predicted infant birth weights (gm) and birth weight differences (with 95% CI) at a maternal pre-pregnancy body mass index of 25, 30, 35, and 45 kg/m² in NHW and NHB with and without diabetes.

<p>Results listed for maternal age of 26, gestational age 38 weeks, gestational weight gain 11.25 kg, averaged over effects for dichotomous factors.</p

Model Two: Predicted infant birth weights (gm) and birth weight differences (with 95% CI) at gestational weight gain (GWG) of 9, 13.5, 18, and 30 kg in NHW and NHB with and without diabetes.

<p>Results listed for maternal age of 26, gestational age 38 weeks, prepregnancy BMI 30, averaged over effects for dichotomous factors.</p

Flow chart defining study population and exclusions.

<p>Flow chart defining study population and exclusions.</p