LINDER Tina

Novel Diagnostic and Treatment Approaches and Their Influence on Maternal and Fetal Outcome in Pregnancies Complicated by Obesity and Gestational Diabetes Mellitus

With a worldwide surge of women affected by overweight or obesity (OW/OB), gestational diabetes mellitus (GDM) also increases, with a global prevalence of around 14%. The consequence of chronic maternal hyperglycemia is an increased fetal weight with subsequent obstetric complications and an elevated risk for childhood obesity and type 2 diabetes in the offspring. OW/OB is a strong risk factors for GDM, and in the presence of GDM, OW/OB increases the risk for adverse pregnancy outcomes. Studies have shown that OW/OB alone is an independent risk factor for early pregnancy loss, large for gestational age new-borns, preeclampsia and intrauterine fetal death. Only scarce data is available on the outcome of small-for-gestational age fetuses of obese women with GDM.

OW/OB is difficult to treat, and bariatric surgery seems to yield the best long-term results. A growing number of pregnancies after bariatric surgery can be seen. However, the effects of bariatric surgery on maternal glucose metabolism, pregnancy outcomes and fetal and neonatal development have not been studied thoroughly yet. The aims of this thesis project are to assess:

- differences in glucose metabolism in pregnancies affected by OW/OB compared to normal weight controls with a special focus on different obesity phenotypes and fetal growth restriction

- differences in glycaemic control between OW/OB and normal weight pregnancies affected by GDM using continuous glucose management systems

- the effect of bariatric surgery on maternal glucose metabolism and pregnancy outcome

Methods and Skills:

Clinical studies

Publications:

Linder T, Dressler-Steinbach I, Tura A, Göbl C. New developments, challenges and open questions in diagnosis and treatment of gestational diabetes mellitus. J Clin Med 11: 7197, 2022

Linder T, Eppel D, Kotzaeridi G, Rosicky I, Yerlikaya-Schatten G, Kiss H, Weißhaupt K, Henrich W, Bozkurt L, Tura A, Roden M, Göbl CS. Fatty liver indices and their association with glucose metabolism in pregnancy - An observational cohort study. Diabetes Res Clin Pract 189: 109942, 2022

Linder T, Eder A, Monod C, Rosicky I, Eppel D, Redling K, Geissler F, Huhn EA, Hösli I, Göbl CS. Impact of prepregnancy overweight and obesity on treatment modality and pregnancy outcome in women with gestational diabetes mellitus. Front Endocrinol (Lausanne) 13: 799625, 2022

and several other publications