scholarly journals How does antenatal lifestyle affect the risk for gestational diabetes mellitus? A secondary cohort analysis from the GeliS trial

2021 ◽  
Author(s):  
Julia Günther ◽  
Julia Hoffmann ◽  
Lynne Stecher ◽  
Monika Spies ◽  
Kristina Geyer ◽  
...  
Keyword(s):  
Mental Health ◽  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Early Pregnancy ◽  
Vigorous Physical Activity ◽  
Significant Risk ◽  
Well Being ◽  
Oral Glucose

Abstract Objectives We aimed to investigate the predictive potential of early pregnancy factors such as lifestyle, gestational weight gain (GWG) and mental well-being on gestational diabetes mellitus (GDM) beyond established risk factors. Methods GDM risk was investigated in the cohort of the German ‘Gesund leben in der Schwangerschaft’/healthy living in pregnancy study. Women were recruited up to the 12th week of gestation. GDM was diagnosed with a 75 g oral glucose tolerance test between the 24th and 28th weeks of gestation. Pre-pregnancy age and weight, mental health and lifestyle were assessed via questionnaires. Maternal weight was measured throughout pregnancy. Early excessive GWG was defined based on the guidelines of the Institute of Medicine. The association between several factors and the odds of developing GDM was assessed using multiple logistic regression analyses. Results Of 1694 included women, 10.8% developed GDM. The odds increased with pre-pregnancy BMI and age (women with obesity: 4.91, CI 3.35–7.19, p < 0.001; women aged 36–43 years: 2.84, CI 1.45–5.56, p = 0.002). Early excessive GWG, mental health and general lifestyle ratings were no significant risk factors. A 31% reduction in the odds of GDM was observed when <30% of energy was consumed from fat (OR 0.69, CI 0.49–0.96, p = 0.026). Vigorous physical activity tended to lower the odds without evidence of statistical significance (OR 0.59 per 10 MET-h/week, p = 0.076). Conclusions Maternal age and BMI stand out as the most important drivers of GDM. Early pregnancy factors like dietary fat content seem to be associated with GDM risk. Further evaluation is warranted before providing reliable recommendations.

scholarly journals High probability of false-positive gestational diabetes mellitus diagnosis during early pregnancy

2020 ◽  
Vol 8 (1) ◽  
pp. e001234
Author(s):  
Sayuri Nakanishi ◽  
Shigeru Aoki ◽  
Junko Kasai ◽  
Ryosuke Shindo ◽  
Soichiro Obata ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Early Pregnancy ◽  
Therapeutic Intervention ◽  
False Positive ◽  
Early Onset ◽  
Oral Glucose ◽  
Study Cohort ◽  
Iadpsg Criteria

IntroductionThis study aimed to assess the validity of applying the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria for the diagnosis of gestational diabetes mellitus (GDM) at any time during pregnancy.Research design and methodsThis multicenter cohort study was conducted at five Japanese facilities from January 2018 to April 2019. The study cohort included women at a high risk of GDM who met one or more of the following IADPSG criteria during early pregnancy: fasting plasma glucose (FPG) ≥92 mg/dL and 75 g oral glucose tolerance test (OGTT) value of ≥180 mg/dL at 1 hour, or ≥153 mg/dL at 2 hour (hereafter early-onset GDM). Women diagnosed with early-onset GDM were followed up without therapeutic intervention and underwent the 75 g OGTT again during 24–28 weeks of gestation. Those exhibiting the GDM patterns on the second 75 g OGTT were diagnosed with true GDM and treated, whereas those exhibiting the normal patterns were diagnosed with false positive early GDM and received no therapeutic intervention.ResultsOf the 146 women diagnosed with early-onset GDM, 69 (47%) had normal 75 g OGTT values at 24–28 weeks of gestation, indicating a false-positive result. FPG levels were significantly higher in the first 75 g-OGTT test than in the second 75 g-OGTT test (93 mg/dL and 87.5 mg/dL, respectively; p<0.001). FPG levels were high in 86 (59%) women with early-onset GDM during early pregnancy but in only 39 (27%) women during mid-pregnancy. Compared with false positive early GDM, true GDM was more frequently associated with adverse pregnancy outcomes.ConclusionsAlthough women with early-onset GDM were followed up without treatment, the results of repeated 75 g OGTT during mid-pregnancy were normal in about 50%. Our data did not support the adoption of IADPSG thresholds for the diagnosis of GDM prior to 20 weeks of gestation.

scholarly journals Prevalence of gestational diabetes mellitus and perinatal outcome: a rural tertiary teaching hospital based study

2017 ◽  
Vol 6 (8) ◽  
pp. 3594 ◽  
Author(s):  
Ke Manga Reddy ◽  
Lakshmi Sailaja P. ◽  
Sahithi Balmuri ◽  
Avinash Jagarlamudi ◽  
Kalpana Betha
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Teaching Hospital ◽  
Perinatal Outcome ◽  
Oral Glucose ◽  
Increased Risk ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital

Background: Gestational diabetes mellitus is the commonest medical disorder in pregnancy. Women with GDM are at increased risk for adverse obstetric and perinatal outcome. Prevalence of GDM is known to vary widely depending on region of the country, dietary habits and socio-economic status. This study was undertaken to evaluate the prevalence of GDM and risk factors associated with it among women delivered in a rural tertiary teaching hospital in Telangana and further assess its impact on feto-maternal outcome.Methods: A retrospective study was conducted at Mediciti Institute of Medical Sciences on GDM cases delivered from May 2015 to April 2017. GDM was diagnosed using 2 step procedure of screening with glucose challenge test followed by confirmation with oral glucose tolerance test using Carpenter and Couston criteria. Demographic data and details about perinatal outcome were obtained from medical records and analyzed.Results: The prevalence was low (1.83%) compared to other studies. Majority of the women did not have risk factors. Preeclampsia is the commonest maternal complication seen (18%). Hypothyroidism is more often associated with GDM (15%). Caesarean section rate was high (62%). Though the NICU admission rate was high (76%), neonatal outcome was found to be satisfactory.Conclusions: The low prevalence of GDM seen highlights the importance of carrying out studies in different population groups of India to know the exact prevalence of GDM in the country. Pregnancies in women with GDM continue to be at increased risk of maternal and perinatal complications.

scholarly journals Risk Factors for Pregnancy Complications and Postpartum Glucose Intolerance in Women With Gestational Diabetes Mellitus

2020 ◽  
Author(s):  
Naohisa Masuko ◽  
Kenji Tanimura ◽  
Nobue Kojima ◽  
Hitomi Imafuku ◽  
Masashi Deguchi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Glucose Intolerance ◽  
Pregnancy Complications ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Hba1c Levels

Abstract This prospective cohort study aimed to evaluate the risk factors for pregnancy complications and postpartum glucose intolerance (GI) in women with gestational diabetes mellitus (GDM). A total of 140 women with GDM were enrolled. Of these, 115 underwent a 75-g oral glucose tolerance test (OGTT) at 12 weeks after delivery. Clinical factors and parameters in the antepartum 75-g OGTT associated with pregnancy complications and postpartum GI were evaluated. Women with GDM experienced pregnancy complications, including hypertensive disorders of pregnancy (HDP, n=19), preterm delivery (PD, n=17), heavy-for-date (HFD, n=19), and light-for-date (LFD, n=12), and 22 of the 115 women with GDM developed postpartum GI. The univariate and multivariable logistic regression analyses revealed the following risk factors: histories of hypertension (odds ratio [OR], 23.8; 95% confidence interval [CI], 4.2–134.7; p<0.01) for HDP; histories of hypertension (OR, 9.8; 95% CI, 2.5–38.9; p<0.01) for PD; HbA1c levels (OR, 7.6; 95% CI, 1.5–37.9; p<0.05) for HFD; and oral deposition index (DI) (OR, 0.1; 95% CI, 0.02–0.7; p<0.01) for postpartum GI. Higher HbA1c levels and lower oral DI on the antepartum 75-g OGTT may be useful markers for identifying GDM women who are at high risk for HFD and postpartum GI, respectively.

Incidence of Risk Factors on the Onset of Gestational Diabetes Mellitus

2012 ◽  
Vol 2 (3) ◽  
pp. 8-22
Author(s):  
E. De Franchis ◽  
A. Ferramosca ◽  
V. Zara ◽  
L. Piper
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Risk Factors ◽  
Family History ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Close Association ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Total Period

In this study the authors evaluated the prevalence of Gestational Diabetes Mellitus (GDM) and the incidence in determining the occurrence thereof, given by the following risk factors: age, family history for Diabetes Mellitus (DM), Body Mass Index (BMI), smoking, diet, macrosomia in previous pregnancies and physical activity. To this end, they investigated a cohort of 61 pregnant women, who had at least one risk factor, in a total period of nine months, during which women checked in the Clinic of Endocrinology and Diabetology of the Hospital “F. Ferrari” in Casarano (Lecce) Italy, and were subjected to an anamnestic investigation and then to a diagnostic test (Oral Glucose Tolerance Test, OGTT 75 g). The anamnesis has allowed to identify the type of risk factors that are present in the population, while the OGTT has allowed to diagnose gestational diabetes. Later, an analysis of the cross-collected data was performed in order to evaluate the percentage incidence of the disease, in relation to risk factors observed. The authors’ results confirmed a prevalence of GDM of 26.23% and the existence of a close association between risk factors and GDM. In particular, the risk factors, macrosomia, BMI = 25 kg/m2, a hypercaloric diet, light physical activity, and age = 35 years, seem to have more influence than smoking and family history for DM, inducing the onset of the illness.

scholarly journals High Fasting Plasma Glucose during Early Pregnancy: A Review about Early Gestational Diabetes Mellitus

2017 ◽  
Vol 2017 ◽  
pp. 1-12 ◽  
Author(s):  
E. Cosson ◽  
L. Carbillon ◽  
P. Valensi
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Early Pregnancy ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Hypoglycemic Agents ◽  
Early Management ◽  
Fasting Plasma

Fasting plasma glucose (FPG) is nowadays routinely measured during early pregnancy to detect preexisting diabetes (FPG ≥ 7 mmol/L). This screening has concomitantly led to identify early intermediate hyperglycemia, defined as FPG in the 5.1 to 6.9 mmol/L range, also early gestational diabetes mellitus (eGDM). Early FPG has been associated with poor pregnancy outcomes, but the recommendation by the IADPSG to refer women with eGDM for immediate management is more pragmatic than evidence based. Although eGDM is characterized by insulin resistance and associated with classical risk factors for type 2 diabetes and incident diabetes after delivery, it is not necessarily associated with preexisting prediabetes. FPG ≥ 5.1 mmol/L in early pregnancy is actually poorly predictive of gestational diabetes mellitus diagnosed after 24 weeks of gestation. An alternative threshold should be determined but may vary according to ethnicity, gestational age, and body mass index. Finally, observational data suggest that early management of intermediate hyperglycemia may improve prognosis, through reduced gestational weight gain and potential early introduction of hypoglycemic agents. Considering all these issues, we suggest an algorithm for the management of eGDM based on early FPG levels that would be measured in case of risk factors. Nevertheless, interventional randomized trials are still missing.

scholarly journals To study the incidence of gestational diabetes mellitus and risk factors associated with GDM

2017 ◽  
Vol 4 (1) ◽  
pp. 112 ◽  
Author(s):  
Maxima Anand ◽  
Manan Anand ◽  
Devinder Singh Mahajan
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Family History ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Challenge Test ◽  
Oral Glucose ◽  
Family History Of Diabetes ◽  
Glucose Levels ◽  
History Of

Background: Diabetes is estimated to complicate 2-5% of all pregnancies of which 90% of those are detected during pregnancy i.e. gestational diabetes mellitus (GDM) and the rest are overt or pregestational i.e. either Type 1 or Type 2. According to ADA, approximately 7% of all pregnancies are complicated by GDM resulting in more than 2,00,000 cases annually. The aim was to study the incidence of GDM among pregnant women between 24 to 28 weeks of gestation, to evaluate and compare the occurrence of risk factors e.g.; family history of diabetes, prematurity, history of foetal loss and congenital anomaly associated with diabetes in pregnancy.Methods: 50gm of glucose, glucose challenge test (GCT) was given to women coming for antenatal check-up between 24 to 28 weeks of gestation irrespective of presence or absence of risk factors for GDM.1 hour glucose levels were checked. Patients with glucose levels more than 130mg/dl were subjected to 100gm of oral glucose tolerance test (OGTT) according to Carpenter and Coustan modification of the National Diabetes Data. Data was compiled and statistically analysed.Results: In this study it was observed that 20 (women had raised GCT, 11 (5.3%) women developed GDM out of 206 women. All GDM patients have one or more risk factors. Age >25 years (63.6%) fetal loss (36.3%), BMI (33.3%) are common risk factors followed by family history of diabetes (27.3%).Conclusions: Family history of diabetes and past history of congenital anomalies are statistically significant in GDM group as compared to non GDM.

scholarly journals Association of maternal folate and vitamin B12 in early pregnancy with gestational diabetes mellitus: a prospective cohort study

2020 ◽  
Author(s):  
Xiaotian Chen ◽  
Yi Zhang ◽  
Hongyan Chen ◽  
Yuan Jiang ◽  
Yin Wang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Early Pregnancy ◽  
Tolerance Test ◽  
Folic Acid Supplementation ◽  
Serum Folate ◽  
Oral Glucose ◽  
Vitamin B

<strong>OBJECTIVE</strong> <p>To investigate the association of folate and<b> </b>vitamin B<sub>12 </sub>in early pregnancy with gestational diabetes mellitus (GDM) risk.</p> <p> </p> <p><strong>RESEARCH DESIGN AND METHODS</strong> </p> <p><a></a><a>The data of this study were from a sub-cohort within the Shanghai Preconception Cohort Study. We included pregnancies with red blood cell (RBC) folate and vitamin B<sub>12</sub> measurements at recruitment (between </a><a>9-13 gestational weeks</a>) and those with three samples available for glucose measurements under oral glucose tolerance test (OGTT). GDM was diagnosed between 24-28 weeks gestation. <a>Odds ratio (OR) </a>of having a GDM and 95% confidence interval (CI) was used to quantify the association. </p> <p> </p> <p><strong>RESULTS</strong> </p> <p><a></a><a>A total of 1,058 pregnancies were included and 180 GDM occurred (17.01%).</a> RBC folate and vitamin B<sub>12 </sub>were significantly higher in pregnancies with GDM than those without GDM (<i>P</i> values were 0.045 and 0.002 respectively), and positively correlated with 1-hour and 2-hour serum glucose. Daily folic acid supplementation in early pregnancy increases the risk of GDM, OR (95% CI) was 1.73 (1.19-2.53), <i>P</i>=0.004. Compared with RBC folate <400 ng/mL, pregnancies with RBC folate ³600 ng/mL was associated with approximately 1.60-fold higher odds of GDM, the adjusted OR (95% CI) was 1.58 (1.03-2.41), <i>P</i>=0.033. A significant trend of risk effect on GDM risk across categories of RBC folate was observed (<i>P</i><sub>trend</sub> =0.021). Vitamin B<sub>12</sub> was significantly associated with GDM risk (OR =1.14 per 100 pg/ml, <i>P</i>=0.002). No significant association of serum folate and percentile ratio of RBC folate/vitamin B<sub>12</sub> with GDM was observed.</p> <p> </p> <p><strong>CONCLUSIONS</strong> </p> <p><a>Higher </a>maternal RBC folate and vitamin B<sub>12 </sub>levels<sub> </sub>in early pregnancy are significantly associated with GDM risk, while the balance of folate/vitamin B<sub>12</sub> is not significantly associated with GDM.</p>

scholarly journals Effects of Risk Factors for Pregnancy Outcomes of Subsequent Pregnancy Associated with Gestational Diabetes Mellitus: A Retrospective Cohort Study in China.

2021 ◽  
Author(s):  
Weijiao Xu ◽  
Xia Xu ◽  
Yanni Guo ◽  
Jie Liang ◽  
Jianying Yan
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Early Pregnancy ◽  
Child Outcomes ◽  
Fasting Blood Glucose ◽  
Neonatal Outcomes ◽  
Lipid Levels

Abstract BackgroundSince the implementation of the three‑child policy in China, the number of high-risk pregnant women has increased, causing serious challenges to health care during pregnancy. In this article, we aimed to investigate the impact of several risk factors for maternal and neonatal outcomes in pregnancies complicated by gestational diabetes mellitus (GDM) and recurrent GDM to formulate a management strategy to minimize the effect of risk factors for gestational diabetes. ResultsPre-pregnancy body mass index (BMI) and gestational weight gain affect maternal and child outcomes in the first and second onset of GDM. Pregnancy interval and fasting blood glucose in early pregnancy influence maternal and child outcomes of recurrent GDM. Maternal lipid levels during early pregnancy have a marked influence on neonatal outcomes in recurrent GDM.ConclusionsOn the basis of this result, weight management should be closely monitored before and during pregnancy. For planning of the second pregnancy with a previous history of GDM, a reasonable time between pregnancies is ideal. Moreover, in the next pregnancy, control of fasting blood glucose and lipid levels during the first trimester is necessary to improve both maternal and child outcomes.

scholarly journals Differing risk factors for new onset and recurrent gestational diabetes mellitus in multipara women: a cohort study

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Li Zhang ◽  
Wei Zheng ◽  
Wenyu Huang ◽  
Lirui Zhang ◽  
Xin Liang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Early Pregnancy ◽  
Subsequent Pregnancy ◽  
Newly Diagnosed ◽  
Singleton Pregnancy ◽  
Increased Risk ◽  
History Of

Abstract Objectives To assess whether recurrent gestational diabetes mellitus (GDM) and newly diagnosed GDM share similar risk factors. Methods The study recruited a cohort of 10,151 multipara women with singleton pregnancy who delivered between 2016 and 2019 in Beijing, China. The prevalence of recurrent GDM and associated risk factors were analyzed between women with and without prior GDM history. Results Eight hundred and seventy-five (8.6%) multipara women had a diagnosis of GDM during previous pregnancies. The prevalence of GDM and pre-gestational diabetes mellitus were 48.34% (423/875) and 7.89% (69/875) if the women were diagnosed with GDM during previous pregnancies, as compared to 16.00% (1484/9276) and 0.50% (46/9276) if the women were never diagnosed with GDM before. In women without a history of GDM, a variety of factors including older maternal age, higher pre-pregnancy body mass index (PPBMI), prolonged interval between the two pregnancies, higher early pregnancy weight gain, family history of type 2 diabetes mellitus (T2DM), maternal low birth weight, and higher early pregnancy glycemic and lipid indexes were generally associated with an increased risk of GDM at subsequent pregnancy. In women with a history of GDM, higher PPBMI, higher fasting glucose level and maternal birthweight ≥4000 g were independent risk factors for recurrent GDM. Conclusions GDM reoccurred in nearly half of women with a history of GDM. Risk factors for recurrent GDM and newly diagnosed GDM were different. Identifying additional factors for GDM recurrence can help guide clinical management for future pregnancies to prevent GDM recurrence.

Sign in / Sign up

Export Citation Format

Share Document