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.

scholarly journals Recurrence of Gestational Diabetes Mellitus: To Assess Glucose Metabolism and Clinical Risk Factors at the Beginning of a Subsequent Pregnancy

2021 ◽  
Vol 10 (20) ◽  
pp. 4794
Author(s):  
Grammata Kotzaeridi ◽  
Julia Blätter ◽  
Daniel Eppel ◽  
Ingo Rosicky ◽  
Veronica Falcone ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Glucose Metabolism ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Cell Function ◽  
Subsequent Pregnancy ◽  
Increased Risk ◽  
Β Cell Function ◽  
History Of

Women with a history of gestational diabetes mellitus (GDM) are at high risk of developing hyperglycemia in a subsequent pregnancy. This study aimed to assess parameters of glucose metabolism at the beginning of a subsequent pregnancy in women with a history of GDM. This prospective cohort study included 706 women who had at least one previous pregnancy (120 with prior GDM and 586 without GDM history). All study participants received a broad risk evaluation and laboratory testing at the beginning of a subsequent pregnancy and were followed up until delivery to assess GDM status, risk factors for GDM recurrence, and pregnancy outcomes. Women with a history of GDM exhibited lower insulin sensitivity and subtle impairments in β-cell function associated with subclinical hyperglycemia already at the beginning of a subsequent pregnancy compared to women without GDM history. This was associated with a markedly increased risk for the later development of GDM (OR: 6.59, 95% CI 4.34 to 10.09, p < 0.001). Early gestational fasting glucose and HbA1c were identified as the most important predictors. Mothers with a history of GDM showed marked alterations in glucose metabolism at the beginning of a subsequent pregnancy, which explains the high prevalence of GDM recurrence in these women.

A prospective study of early-pregnancy thyroid markers, lipid species, and risk of gestational diabetes mellitus

2021 ◽  
Author(s):  
Yi Wang ◽  
Fengjiang Sun ◽  
Ping Wu ◽  
Yichao Huang ◽  
Yi Ye ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Early Pregnancy ◽  
Maternal Serum ◽  
Thyroid Peroxidase ◽  
Free Triiodothyronine ◽  
Composite Effect ◽  
Lipid Species ◽  
Increased Risk

Abstract Context While the associations between thyroid markers and gestational diabetes mellitus (GDM) have been extensively studied, the results are inconclusive and the mechanisms remain unclear. Objective We aimed to investigate the prospective associations of thyroid markers in early gestation with GDM risk, and examine the mediating effects through lipid species. Methods This study included 6068 pregnant women from the Tongji-Shuangliu Birth Cohort. Maternal serum thyroid markers (free triiodothyronine (fT3), free thyroxine (fT4), thyroid-stimulating hormone, thyroid peroxidase antibody, and thyroglobulin antibody) were measured before 15 weeks. Deiodinase activity was assessed by fT3/fT4 ratio. Plasma lipidome were quantified in a subset of 883 participants. Results Mean age of the participants was 26.6 ± 3.7 years, and mean gestational age was 10.3 ± 2.0 weeks. Higher levels of fT4 were associated with a decreased risk of GDM (OR=0.73 comparing the extreme quartiles; 95% CI 0.54, 0.98, Ptrend =0.043), while higher fT3/fT4 ratio was associated with an increased risk of GDM (OR=1.43 comparing the extreme quartiles; 95% CI 1.06, 1.93, Ptrend =0.010) after adjusting for potential confounders. Multiple linear regression suggested that fT3/fT4 ratio was positively associated with alkylphosphatidylcholine 36:1, phosphatidylethanolamine plasmalogen 38:6, diacylglyceride 18:0/18:1, sphingomyelin 34:1, and phosphatidylcholine 40:7 (false discovery rate adjusted P&lt;0.05). Mediation analysis indicated 67.9% of the association between fT3/fT4 ratio and GDM might be mediated through the composite effect of these lipids. Conclusions Lower concentration of serum fT4 or higher fT3/fT4 ratio in early pregnancy was associated with an increased risk of GDM. The association of fT3/fT4 ratio with GDM was largely mediated by specific lipid species.

scholarly journals Study of Risk Factors for Conegnital Heart Defect in a Tertiary Level Hospital

2018 ◽  
Vol 27 (1) ◽  
pp. 51-56
Author(s):  
Ferdousi Hossain Poly ◽  
Syeda Afroza ◽  
Hasanur Rahman ◽  
Md Imran Hassan
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Maternal Age ◽  
Congenital Heart ◽  
Heart Defects ◽  
Medical College ◽  
History Of ◽  
The Difference

A congenital heart defect is a heart problem which is present at birth, caused by improper development of the heart during fetal development. In majority of cases there is no known reason for the heart to develop improperly. Some type of congenital heart defects are related to chromosomal abnormality(5-6%), some are to single gene defect(3-5%) or environmental factors(2%). In 85-90% of cases there is no identifiable cause and are generally considered to be caused by multifactorial inheritance. There are some maternal factors which have some role in cardiovascular malformations. These include high maternal age(above 30 years), maternal obesity, consanguinity among the parents, fever during pregnancy, gestational diabetes mellitus, smoking, alcohol consumption, ingestion of any teratogenic drug including homeopathy and herbal medicine. Objective of the study: To evaluate the risk factors associated with congenital heart disease. Methodology: A case control study was conducted at paediatric department of Sir Salimullah Medical College & Mitford Hospital following approval of the protocol from 1st January 2013 to 30th June 2014. Children fulfilling the inclusion criteria-(0-5 year old children of both sexes admitted in paediatric units of Mitford Hospital with any type of congenital heart disease confirmed by echocardiography) were considered as cases. A similar number of age and sex matched children admitted in Mitford Hospital without any cardiac defect were considered as controls. Data were collected by questionnaire. Results: The results show that majority of the cases are male. Maternal age (27.09 ± 4.63) and BMI (24.10 ± 2.28) both are significantly higher in cases than those of controls. Among the cases 31.8% mothers had consanguineous marriage (p=0.001) and 27.1% mothers had history of fever during pregnancy whereas it was present in 9.3% mothers of controls, the difference is significant statistically (p=0.001). Among the cases 34.6% mothers had history of gestational diabetes mellitus and only 18.9% controls had so and the difference is significant statistically (p=0.014). Conclusion: Relatively old age and more weight during pregnancy, consanguinity between parents, fever during pregnancy, history of gestational diabetes mellitus are the main risk factors of congenital heart defects in children J Dhaka Medical College, Vol. 27, No.1, April, 2018, Page 51-56

scholarly journals Risk factor for gestational diabetes mellitus and impact of gestational diabetes mellitus on maternal and fetal health during the antenatal period

2021 ◽  
Author(s):  
Uma Jain ◽  
Kusumlata Singhal ◽  
Shikha Jain ◽  
Deepali Jain
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Congenital Malformation ◽  
Fetal Health ◽  
Antenatal Period ◽  
Study Results ◽  
History Of ◽  
The Impact

Background: Gestational diabetes mellitus (GDM) is defined as any degree of dysglycaemia that occurs for the first time or is first detected during pregnancy. The adverse effects of GDM on pregnant women are pre-eclampsia, PIH, PPH, polyhydramanios, PROM, meanwhile, there would be an increase in dystocia, birth injury, and cesarean sectionMethods: This retrospective study was conducted in a Gynecology clinic in District Shivpuri to find out the various risk factors for GDM and to evaluate the impact of GDM on maternal and fetal health during the antenatal period. 84 patients who were diagnosed with GDM were included in the study. Results: Among risk factors; BMI >25 kg/m2 before pregnancy was found in 15.47% of the case, family history of diabetes mellitus 8.33%, Previous history of macrosomia 17.85%, Poor reproductive history 17.85%, baby with congenital malformation 8.33%, H/o unexplained IUFD 11.90%. H/o polyhydramnios 15.47%. History of PCOS 13.09% and preeclampsia was found in 17.85% of cases. In antenatal complications; miscarriages was found in 15.47%. polyhydramnios in 17.85%. Oligohydramnios in 8.33%, preterm labor in 11.90%, PROM in 9.52%, pre-eclampsia in 17.85%, sudden IUFD in 8.33% and congenital malformation was found in 4.76% of cases. On USG; IUGR was found in 7.14% of cases. Large for date fetus in 16.66% of cases and the normal growth was found in 76.19% of cases.Conclusions- In conclusion appropriate and timely diagnosis and treatment of GDM will result in decreased maternal and neonatal adverse outcomes comparable to general population rates, therefore, early diagnosis is important.

scholarly journals Burden, risk factors and maternal and offspring outcomes of gestational diabetes mellitus (GDM) in sub-Saharan Africa (SSA): a systematic review and meta-analysis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Barnabas Kahiira Natamba ◽  
Arthur Araali Namara ◽  
Moffat Joha Nyirenda
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Meta Analysis ◽  
Previous History ◽  
Sub Saharan Africa ◽  
African Women ◽  
History Of ◽  
Sub Saharan

Abstract Background The burden, determinants and outcomes of gestational diabetes mellitus (GDM) in sub-Saharan Africa are not known. We summarized existing evidence on the prevalence, risk factors and complications of GDM in the region. Methods PubMed was searched from inception to January 31st 2019. Studies were included if carried out in any of the sub-Saharan Africa countries and were available as abstracts or full texts. Interventional studies and those only including qualitative data were excluded. We employed random effects modelling to estimate the pooled GDM prevalence and risk ratios (RRs) for risk factors and outcomes of GDM and their 95%CI. Results 283 papers were identified in the initial search, 33 of which met the inclusion criteria. Data on GDM burden suggest a pooled prevalence of 9% (95%CI, 7–12%). Family history of type 2 diabetes and previous history of GDM, macrosomia, stillbirth and abortion were important risk factors of GDM. In addition, being overweight or obese, over 25 years of age or hypertensive increased the risk of GDM. In terms of complications, GDM more than doubles the risk macrosomia (RR; 95%CI: 2.2; 1.1–4.4). Conclusions There is a high burden of gestational diabetes mellitus in sub-Saharan Africa, but more studies are needed to document locally important risk factors as well as maternal and offspring outcomes. Interventions to reduce obesity among older African women might lead to reduced risk of GDM in sub-Saharan Africa.

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 Prevalence of Gestational Diabetes Mellitus and Maternal and Fetal Outcomes at the Rivers State University Teaching Hospital (RSUTH), Port Harcourt, Nigeria

2020 ◽  
pp. 1-16
Author(s):  
D. H. John ◽  
P. A. Awoyesuku ◽  
D. A. MacPepple ◽  
N. J. Kwosah
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Exposed Group ◽  
Fetal Outcomes ◽  
Previous Pregnancy ◽  
Increased Risk ◽  
History Of

Background: Gestational diabetes mellitus (GDM) is a common cause of hyperglycaemia in pregnancy accounting for about 90% of all diabetic pregnancies. Women with GDM are at increased risk of maternal and fetal morbidity and mortality which are preventable through early diagnosis and treatment. Objective: The aim was to determine the prevalence of GDM, compare the maternal and neonatal complications among GDM and non-GDM pregnant women, and the risk factors associated with GDM. Methodology: A prospective cohort study was carried out among 105 pregnant women attending the antenatal clinic of RSUTH between February and August 2017. They were interviewed using a pre-structured questionnaire that covered variables related to socio-demographic factors and family, medical, and social history. Fasting blood sugar (FBS) was done after an overnight fast. Women who had FBS less than 7 mmol/L had 75 g Oral Glucose Tolerant Test (OGTT) done. Those diagnosed with gestational diabetes mellitus were the exposed group while those negative for GDM were the non-exposed group. Both groups were followed up to delivery, and maternal and fetal outcomes were noted. Statistical analysis was carried out using SPSS version 20 and significance set at p < 0.05. Results: The prevalence of GDM was 10.5%. Positive history of GDM in previous pregnancy was the only independent risk factor (p=0.04, Adj OR: 26.89, 95% CI 2.86 to 252.61). GDM mothers had a significantly higher risk of developing pre-eclampsia (RR=7.48; 95% CI =3.36 to 16.63). Neonates of GDM mothers were at increased risk of fetal macrosomia (RR =9.00; 95% CI=1.36 to 59.4) and neonatal admissions (RR=8.00; C.I =1.19 to 53.67). Conclusion: The study revealed that the prevalence of GDM was high and that those with GDM were at increased risk of developing fetal and maternal complications. A history of GDM in previous pregnancy was an essential risk factor for subsequent GDM.

Sign in / Sign up

Export Citation Format

Share Document