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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2023

Open Access 01-12-2023 | Hyperglycemia | Research article

Impact of experiencing multiple vulnerabilities on fetal growth and complications in women with hyperglycemia in pregnancy

Authors: Helene Bihan, Charlotte Nachtargeale, Eric Vicaud, Meriem Sal, Narimane Berkane, Sara Pinto, Sopio Tatulashvili, Marion Fermaut, Lionel Carbillon, Emmanuel Cosson

Published in: BMC Pregnancy and Childbirth | Issue 1/2023

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Abstract

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

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

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

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.
Appendix
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Metadata
Title
Impact of experiencing multiple vulnerabilities on fetal growth and complications in women with hyperglycemia in pregnancy
Authors
Helene Bihan
Charlotte Nachtargeale
Eric Vicaud
Meriem Sal
Narimane Berkane
Sara Pinto
Sopio Tatulashvili
Marion Fermaut
Lionel Carbillon
Emmanuel Cosson
Publication date
01-12-2023
Publisher
BioMed Central
Keyword
Hyperglycemia
Published in
BMC Pregnancy and Childbirth / Issue 1/2023
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-023-06048-9

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