Neonatal complications and risk factors among women with gestational diabetes mellitus.

OBJECTIVE: This study aimed to identify risk factors for gestational diabetes mellitus (GDM) and assess the effects of GDM on the risk of adverse pregnancy outcomes. MATERIAL AND METHODS: This was a cross-sectional study using data from the German Perinatal Quality Registry, which is a complete national registry containing information on all hospital births across Germany. The Registry for 2006 contains data on a complete birth cohort of 668,085 newborn infants and 647,392 mothers from all 896 German hospitals. All data were taken from maternity log records and analyzed by multivariate logistic regression. Each recorded case of GDM was identified by a gynecologist or in hospital. RESULTS: The prevalence of GDM was 2.3% (14,990 of 647,385). High-risk groups were migrants, women of lower socioeconomic status (adjusted odds ratio 1.16, 95% confidence interval 1.05-1.28) and obese women (adjusted odds ratio 4.96, 95% confidence interval 4.70-5.24). A higher risk of fetal malformations was found for those diagnosed with GDM (adjusted odds ratio 1.32, 95% confidence interval 1.15-1.53). CONCLUSION: The higher risk of fetal malformations with GDM suggests that many of these women may have high glucose levels even during the first trimester. Policies and interventions regarding prenatal care should therefore focus not only on how better diagnostic and treatment procedures can be implemented, but also on how they can reach older and migrant women as well as women of lower socioeconomic status.

Risk groups and maternal-neonatal complications of preeclampsia--current results from the national German Perinatal Quality Registry.

AIMS: We investigated risk factors and neonatal outcomes of preeclampsia. METHODS: We analyzed data of the German Perinatal Quality Registry 2006 that contains the complete national birth cohort of 668,085 newborn infants and 647,392 mothers from 917 German obstetric clinics. RESULTS: The prevalence of preeclampsia in 2006 was at 2.31%. Higher maternal age, gestational diabetes, no previous as well as multiple births, pre-pregnancy obesity and above-average weight gain during pregnancy were significantly associated with preeclampsia. A positive relationship between social burden (e.g., low social status, psychosocial stress) and the risk of preeclampsia appeared. Smoking appeared to be negatively correlated. Neonatal complications associated with preeclampsia in the study were small babies, acute respiratory distress syndrome, postpartum neonatal hypoglycemia and low Apgar scores. We did not observe an increased rate of stillbirths with preeclampsia pregnancies. CONCLUSIONS: Further studies and interventions regarding prenatal care should not focus only on how better diagnostic and treatment procedures can be implemented but also on how these diagnostic and treatment procedures can reach high-risk groups.

What prevents young adolescents from smoking? Self-reported motives of 12-15-year-old non-smokers.

OBJECTIVES: This study investigated the real motives of German non-smokers. METHODS: In the German SToP ("Sources of Tobacco for Pupils") Study 707 non-smoking pupils were asked to write down their motives for being non-smokers. A total of 1324 partially very elaborate free text statements (mean/range: 1.9/1-7 distinguishable motives) were evaluated in a qualitative content analysis. RESULTS: The most important and frequently mentioned motives for not smoking were health-related arguments (78.1%). Except for cancer significant main health risks of tobacco consumption like cardio- and cerebrovascular diseases or COPD were hardly perceived. Further important reasons were an aesthetic aversion (38.6%), missing perception of a benefit (25.2%), and economic motives (20.8%). Girls and pupils from academic high schools named aesthetic motives significantly more often than boys and pupils from secondary schools respectively. A historical comparison shows that the motive "lacking benefit" reached a higher rank in our study than in the 1990s. CONCLUSIONS: When non-smokers are asked directly, extrinsic reasons (restrictions, smoking bans) do not seem to be relevant for them. Reasons concerning health, good physical shape, and beauty should be a central argument in the medical practise with young smokers.