Air pollution exposure and gestational diabetes mellitus among pregnant women in Massachusetts: a cohort study

BackgroundPrevious evidence indicates that birth season is associated with type 2 diabetes in adults. However, information on the association of birth with gestational diabetes mellitus (GDM) is lacking. The present study explores the association between birth seasonality and GDM in East China.MethodsThis retrospective cohort study was conducted at the International Peace Maternal and child health hospital between 2014 and 2019. A total of 79, 292 pregnant women were included in the study after excluding participants with previous GDM, stillbirth, polycystic ovary syndrome, and lack of GDM laboratory records. The multivariate logistic regression model was employed to estimate the odds ratio and 95% confidence interval. After log transformation of blood glucose level, the percentage change and 95% confidence interval were estimated by a multivariate linear model.ResultsThe risk of GDM among pregnant women born in spring, autumn, and winter was not significantly different compared to that among participants born in summer. Pregnant women born in autumn had significantly higher 1-hour postprandial blood glucose (PBG-1h) and 2-hour postprandial blood glucose (PBG-2h) levels than pregnant women born in summer. Compared to pregnant women born in August, the PBG-1h level of pregnant women born in October, November, and December increased significantly, whereas the PBG-2h levels of pregnant women born in November and December increased significantly.ConclusionPregnant women born in autumn exhibit higher postprandial blood glucose levels during pregnancy than in those born in summer. The findings provide evidence that exposure to seasonal changes in early life may influence blood glucose metabolism during pregnancy.

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Gestational diabetes mellitus and exposure to ambient air pollution and road traffic noise: A cohort study

Environment International ◽

10.1016/j.envint.2017.09.003 ◽

2017 ◽

Vol 108 ◽

pp. 253-260 ◽

Cited By ~ 27

Author(s):

Marie Pedersen ◽

Sjurdur F. Olsen ◽

Thorhallur I. Halldorsson ◽

Cuilin Zhang ◽

Dorrit Hjortebjerg ◽

...

Keyword(s):

Diabetes Mellitus ◽

Air Pollution ◽

Cohort Study ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Road Traffic ◽

Traffic Noise ◽

Ambient Air ◽

Ambient Air Pollution ◽

Road Traffic Noise

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Proinsulin in the identification and risk stratification of gestational diabetes mellitus: study protocol for a prospective, longitudinal cohort study

BMJ Open ◽

10.1136/bmjopen-2018-022571 ◽

2018 ◽

Vol 8 (8) ◽

pp. e022571

Author(s):

Rajesh Peter ◽

Dominic Bright ◽

Wai-Yee Cheung ◽

Stephen D Luzio ◽

Gareth J Dunseath

Keyword(s):

Diabetes Mellitus ◽

Cohort Study ◽

Gestational Diabetes ◽

Risk Stratification ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Longitudinal Cohort Study ◽

Longitudinal Cohort ◽

Prospective Longitudinal ◽

Prospective Longitudinal Cohort

IntroductionGestational diabetes mellitus (GDM) is a common metabolic disorder occurring in up to 10% of pregnancies in the western world. Most women with GDM are asymptomatic; therefore, it is important to screen, diagnose and manage the condition as it is associated with an increased risk of maternal and perinatal complications. Diagnosis of GDM is made in the late second trimester or early third trimester because accurate diagnosis or risk stratification in the first trimester is still lacking. An increase in serum proinsulin may be seen earlier in pregnancy and before a change in glycaemic control can be identified. This study will aim to establish if fasting proinsulin concentrations at 16–18 weeks gestation will help to identify or risk stratify high-risk pregnant women with GDM.Methods and analysisThis is a prospective, longitudinal cohort study. Two oral glucose tolerance tests will be carried out at 16–18 and 24–28 weeks gestation in 200 pregnant women with at least one risk factor for GDM (body mass index>30 kg/m2, previous macrosomic baby (>4.5 kg), previous gestational diabetes, first degree relative with type 2 diabetes mellitus) recruited from antenatal clinics. Blood samples will be taken fasting and at 30 min, 1 and 2 hours following the 75 g glucose load. In addition, a fasting blood sample will be taken 6-weeks post delivery. All samples will be analysed for glucose, insulin, C peptide and proinsulin. Recruitment began in November 2017. Optimal cut-off points for proinsulin to diagnose gestational diabetes according to National Institute for Health and Care Excellence (2015) criteria will be established by the receiver operating characteristic plot and sensitivity and specificity will be calculated to assess the diagnostic accuracy of proinsulin at 16–18 weeks gestation.Ethics and disseminationThis study received ethical approval from the Wales Research Ethics Committee (Panel 6) (Ref. 17/WA/0194). Data will be presented at international conferences and published in peer-reviewed journals.Trial registration numberISRCTN16416602; Pre-results.

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