1
|
Slouha E, Alvarez VC, Gates KM, Ankrah NMN, Clunes LA, Kollias TF. Gestational Diabetes Mellitus in the Setting of Polycystic Ovarian Syndrome: A Systematic Review. Cureus 2023; 15:e50725. [PMID: 38234933 PMCID: PMC10793469 DOI: 10.7759/cureus.50725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2023] [Indexed: 01/19/2024] Open
Abstract
Gestational diabetes mellitus (GDM) is the most common complication of pregnancy that arises in the 2nd and 3rd trimesters, leading to significant complications for the mother and her neonates, such as an increased rate of pregnancy-induced hypertension and miscarriages, while neonates may have a large birth weight, hypoglycemia, or macrosomnia. Numerous risk factors can lead to GDM; however, a significant one is polycystic ovarian syndrome (PCOS). PCOS is the most common endocrine pathology beginning before puberty, and due to significant hormonal changes, it is not diagnosed until after puberty. PCOS requires at least three of the following symptoms: hyperandrogenism, menstrual irregularities, or polycystic ovary morphology. While it is agreed that women with PCOS are at a significantly increased risk of GDM, no publication to our knowledge has evaluated the full relationship of GDM in the setting of PCOS. This paper aimed to assess this relationship and determine how it may differ for pregnant women with only GDM by determining the prevalence of GDM, the variations within phenotypes, the influence of fertilization methods, specific risk factors, maternal outcomes, and neonatal outcomes. The prevalence of GDM was significantly increased in women with PCOS compared to healthy controls, and some studies have found that phenotype A may be more likely to lead to GDM. Risk factors were similar to pregnant women with only GDM, but with GDM and PCOS specifically, preconception low sex hormone-binding globulin, increased BMI > 25 kg/m2, and preconception impaired glucose tolerance were specific. While maternal outcomes were similar to pregnant women with only GDM, women with GDM and PCOS were even more likely to develop pregnancy-induced hypertension and early miscarriage. Neonates from mothers with GDM and PCOS were more likely to have low birth weights compared to mothers with just GDM who had high birth weights. The evaluation of the relationship between GDM and PCOS allows for illumination of the need to evaluate influences that currently lack research, such as phenotype variation and influences of fertilization method. This also promotes the need to develop predictive algorithms based on risk factors to prevent these adverse outcomes for mothers and neonates.
Collapse
Affiliation(s)
- Ethan Slouha
- Anatomical Sciences, St. George's University School of Medicine, St. George's, GRD
| | - Vanessa C Alvarez
- Pharmacology, St. George's University School of Medicine, St. George's, GRD
| | - Kaitlyn M Gates
- Pharmacology, St. George's University School of Medicine, St. George's, GRD
| | | | - Lucy A Clunes
- Pharmacology, St. George's University, St. George's, GRD
| | - Theofanis F Kollias
- Microbiology, Immunology, and Pharmacology, St. George's University School of Medicine, St. George's, GRD
| |
Collapse
|
2
|
Polycystic ovary syndrome (PCOS) increases the risk of subsequent gestational diabetes mellitus (GDM): A novel therapeutic perspective. Life Sci 2022; 310:121069. [DOI: 10.1016/j.lfs.2022.121069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/03/2022] [Accepted: 10/07/2022] [Indexed: 11/09/2022]
|
3
|
Yan Q, Qiu D, Liu X, Xing Q, Liu R, Hu Y. The incidence of gestational diabetes mellitus among women with polycystic ovary syndrome: a meta-analysis of longitudinal studies. BMC Pregnancy Childbirth 2022; 22:370. [PMID: 35488240 PMCID: PMC9055740 DOI: 10.1186/s12884-022-04690-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/18/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Previous studies have shown that polycystic ovary syndrome is a predictor of gestational diabetes mellitus, but we do not know exactly how many polycystic ovary syndrome patients may develop gestational diabetes mellitus. Currently, the incidence of gestational diabetes mellitus among women with polycystic ovary syndrome varies greatly across studies, ranged from 4.12% to 59.50%. Besides, many factors have been found to be related to the incidence of gestational diabetes mellitus among women with polycystic ovary syndrome, but the results among different studies are not consistent. The possible causes of inconsistencies between the current estimates were unclear. This review aimed at exploring the pooled incidence of gestational diabetes mellitus among women with polycystic ovary syndrome, summarizing possible causes of the inconsistencies in the current estimates, try to provide a reference for prevention of gestational diabetes mellitus and polycystic ovary syndrome in the future. METHODS Systematic searches of different databases (including EMBASE, Web of Science, MEDLINE, The Cochrane Library, CNKI and PubMed) were conducted for studies published until 31 May 2021. Statistical analyses were performed using R software, the pooled incidence of gestational diabetes mellitus among polycystic ovary syndrome patients was combined using random effects model. Cochrane's "Tool to Assess Risk of Bias in Cohort Studies" was used for quality assessment. RESULTS Twenty-two longitudinal studies were included. A total of 24,574 women with polycystic ovary syndrome were identified in the 22 articles, of which 4478 were reported with gestational diabetes mellitus. The pooled incidence of gestational diabetes mellitus among women with polycystic ovary syndrome was 20.64%, with a 95% CI of 14.64% to 28.30%. In the meta-regression model, several variables including age, area, quality score and sample size were suggested as significant sources of heterogeneity, accounted for 77.57% of the heterogeneity across studies. CONCLUSIONS Evidence in this review suggests that gestational diabetes mellitus were common among women with polycystic ovary syndrome. More research is needed to found effective interventions for preventing gestational diabetes mellitus among women with polycystic ovary syndrome.
Collapse
Affiliation(s)
- Qingzi Yan
- Department of Pharmacy, Xiangtan Central Hospital, Hunan, China
| | - Dan Qiu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan China
| | - Xiang Liu
- Department of Pharmacy, Xiangtan Central Hospital, Hunan, China
| | - Qichang Xing
- Department of Pharmacy, Xiangtan Central Hospital, Hunan, China
| | - Renzhu Liu
- Department of Pharmacy, Xiangtan Central Hospital, Hunan, China
| | - Yixiang Hu
- Department of Pharmacy, Xiangtan Central Hospital, Hunan, China
| |
Collapse
|
4
|
Are Dietary Indices Associated with Polycystic Ovary Syndrome and Its Phenotypes? A Preliminary Study. Nutrients 2021; 13:nu13020313. [PMID: 33499268 PMCID: PMC7911683 DOI: 10.3390/nu13020313] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/13/2021] [Accepted: 01/20/2021] [Indexed: 12/25/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is a complex hormonal disorder which impairs ovarian function. The adherence to healthy dietary patterns and physical exercise are the first line of recommended treatment for PCOS patients, but it is yet unclear what type of diet is more adequate. In this case-control study, we explored associations between adherence to five dietary quality indices and the presence of PCOS. We enrolled 126 cases of PCOS and 159 controls living in Murcia (Spain). Diagnostic of PCOS and its phenotypes were established following the Rotterdam criteria (hyperandrogenism (H), oligoanovulation (O), polycystic ovaries morphology (POM)). We used a validated food frequency questionnaires to calculate the scores of five dietary indices: alternate Healthy Eating index (AHEI), AHEI-2010, relative Mediterranean Dietary Score (rMED), alternate Mediterranean Dietary Score (aMED) and Dietary Approaches to Stop Hypertension (DASH). We used multivariable logistic regression to estimate adjusted odds ratios and confidence intervals. In the multivariable analysis, AHEI-2010 index was inversely associated with Hyperandrogenism + Oligoanovulation PCOS phenotype (ORQ3 vs. Q1 = 0.1; 95% CI: (0.0; 0.9); Pfor trend = 0.02). We did not find any statistical significant association between dietary indices and total anovulatory or ovulatory PCOS. However, further studies with higher sample sizes exploring these associations among the diverse phenotypes of PCOS are highly warranted.
Collapse
|
5
|
Palm CVB, Glintborg D, Kyhl HB, McIntyre HD, Jensen RC, Jensen TK, Jensen DM, Andersen M. Polycystic ovary syndrome and hyperglycaemia in pregnancy. A narrative review and results from a prospective Danish cohort study. Diabetes Res Clin Pract 2018; 145:167-177. [PMID: 29689322 DOI: 10.1016/j.diabres.2018.04.030] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 04/17/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Insulin resistance is common in polycystic ovary syndrome (PCOS). PCOS may be associated with increased risk of gestational diabetes mellitus (GDM). OBJECTIVES To (1) review literature regarding PCOS and hyperglycaemia in pregnancy and (2) present original data from Odense Child Cohort (OCC) regarding GDM in PCOS. METHODS Literature search including original studies from 2000-18. OCC included 2548 pregnant women, 9.5% (n = 241) had PCOS. Fasting plasma glucose was measured in 1519 and 659 oral glucose tolerance tests were performed (with risk factor for GDM, n = 384, without risk factors, n = 275), applying two different GDM criteria. RESULTS 30 studies were eligible using 12 different sets of diagnostic criteria for GDM. Ten studies included n > 50, control group, assessment of GDM and BMI. Results were not uniform, but supported that higher BMI, higher age, Asian ethnicity, and fertility treatment increased the risk of GDM in PCOS. In OCC, women with PCOS and controls had similar prevalences of GDM independent of different sets of criteria for GDM. CONCLUSION PCOS may not be an individual risk factor for GDM. Pregnancies in PCOS are characterized by factors known to increase risk of GDM, especially high BMI and fertility treatment.
Collapse
Affiliation(s)
- Camilla Viola Buskbjerg Palm
- Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark; Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Dorte Glintborg
- Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark
| | - Henriette Boye Kyhl
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark; Odense Patient Data Exploratory Network (OPEN), Odense University Hospital, Odense, Denmark
| | - H David McIntyre
- Mater Research, University of Queensland, Brisbane, Australia; Danish Diabetes Academy, Odense University Hospital, Odense, Denmark
| | | | - Tina Kold Jensen
- Odense Patient Data Exploratory Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Dorte Møller Jensen
- Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark; Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Marianne Andersen
- Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark.
| |
Collapse
|
6
|
Metformin versus insulin for gestational diabetes: The reporting of ethnicity and a meta-analysis combining English and Chinese literatures. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.obmed.2018.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
|
7
|
Mustaniemi S, Vääräsmäki M, Eriksson JG, Gissler M, Laivuori H, Ijäs H, Bloigu A, Kajantie E, Morin-Papunen L. Polycystic ovary syndrome and risk factors for gestational diabetes. Endocr Connect 2018; 7:859-869. [PMID: 29858213 PMCID: PMC6026881 DOI: 10.1530/ec-18-0076] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 05/31/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To study the roles of self-reported symptoms and/or prior diagnosis of polycystic ovary syndrome (PCOS) and other potential risk factors for gestational diabetes mellitus (GDM) and to clarify whether the screening of GDM in early pregnancy is beneficial for all women with PCOS. DESIGN The FinnGeDi multicentre case-control study including 1146 women with singleton pregnancies diagnosed with GDM and 1066 non-diabetic pregnant women. There were 174 women with PCOS (symptoms and/or diagnosis self-reported by a questionnaire) and 1767 women without PCOS (data missing for 271). METHODS The study population (N = 1941) was divided into four subgroups: GDM + PCOS (N = 105), GDM + non-PCOS (N = 909), non-GDM + PCOS (N = 69), and controls (N = 858). The participants' characteristics and their parents' medical histories were compared. RESULTS The prevalence of PCOS was 10.4% among GDM women and 7.4% among non-diabetics (odds ratios (OR) 1.44, 95% CI: 1.05-1.97), but PCOS was not an independent risk for GDM after adjustments for participants' age and pre-pregnancy BMI (OR 1.07, 95% CI: 0.74-1.54). In a multivariate logistic regression analysis, the most significant parameters associated with GDM were overweight, obesity, age ≥35 years, participant's mother's history of GDM, either parent's history of type 2 diabetes (T2D) and participant's own preterm birth. CONCLUSIONS The increased risk of GDM in women with PCOS was related to obesity and increased maternal age rather than to PCOS itself, suggesting that routine early screening of GDM in PCOS women without other risk factors should be reconsidered. Instead, family history of GDM/T2D and own preterm birth were independent risk factors for GDM.
Collapse
Affiliation(s)
- Sanna Mustaniemi
- Public Health Promotion UnitNational Institute for Health and Welfare, Helsinki, Finland
- PEDEGO Research UnitMRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Marja Vääräsmäki
- Public Health Promotion UnitNational Institute for Health and Welfare, Helsinki, Finland
- PEDEGO Research UnitMRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Johan G Eriksson
- Department of General Practice and Primary Health CareUniversity of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research CentreHelsinki, Finland
| | - Mika Gissler
- Information Services DepartmentNational Institute for Health and Welfare, Helsinki, Finland
- Division of Family MedicineDepartment of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Hannele Laivuori
- Medical and Clinical GeneticsUniversity of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Obstetrics and GynaecologyTampere University Hospital, Tampere, Finland
- Faculty of Medicine and Life SciencesUniversity of Tampere, Tampere, Finland
- Institute for Molecular Medicine FinlandHelsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Hilkka Ijäs
- Public Health Promotion UnitNational Institute for Health and Welfare, Helsinki, Finland
- PEDEGO Research UnitMRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Aini Bloigu
- PEDEGO Research UnitMRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Eero Kajantie
- Public Health Promotion UnitNational Institute for Health and Welfare, Helsinki, Finland
- PEDEGO Research UnitMRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Children's HospitalUniversity of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Laure Morin-Papunen
- PEDEGO Research UnitMRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| |
Collapse
|
8
|
Xiao Q, Cui YY, Lu J, Zhang GZ, Zeng FL. Risk for Gestational Diabetes Mellitus and Adverse Birth Outcomes in Chinese Women with Polycystic Ovary Syndrome. Int J Endocrinol 2016; 2016:5787104. [PMID: 27066074 PMCID: PMC4808671 DOI: 10.1155/2016/5787104] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 02/18/2016] [Accepted: 02/21/2016] [Indexed: 12/18/2022] Open
Abstract
Objective. To examine the association of polycystic ovary syndrome (PCOS) in early pregnancy with gestational diabetes mellitus (GDM) and adverse birth outcomes. Methods. In this retrospective cohort study including 2389 pregnant women, the medical records of 352 women diagnosed with PCOS were evaluated. Outcomes included GDM, preterm birth, low birth weight, macrosomia, and being small and large for gestational age. Multivariable logistic regression models were used to examine the association of the risk for GDM and adverse birth outcomes with PCOS after adjusting for confounders. Results. Women previously diagnosed with PCOS had a higher risk of GDM (adjusted odds ratio [OR] 1.55, 95% confidence interval [CI]: 1.14-2.09). A strong association was seen between PCOS and preterm birth (adjusted OR 1.69, 95% CI: 1.08-2.67). On stratified analysis, the adjusted OR for GDM among women with PCOS undergoing assisted reproductive technology was 1.44 (95% CI: 1.03-1.92) and among women with PCOS who conceived spontaneously was 1.60 (1.18-2.15). No increased risk for other adverse birth outcomes was observed. Conclusions. Women with PCOS were more likely to experience GDM and preterm birth.
Collapse
Affiliation(s)
- Qing Xiao
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - Yong-Yi Cui
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - Jine Lu
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - Guo-Zheng Zhang
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - Fang-Ling Zeng
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
- *Fang-Ling Zeng:
| |
Collapse
|
9
|
Odsæter IH, Åsberg A, Vanky E, Carlsen SM. HbA1c as screening for gestational diabetes mellitus in women with polycystic ovary syndrome. BMC Endocr Disord 2015; 15:38. [PMID: 26245653 PMCID: PMC4527320 DOI: 10.1186/s12902-015-0039-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Accepted: 07/29/2015] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is associated with adverse pregnancy outcomes such as preeclampsia and macrosomia. Women with polycystic ovary syndrome (PCOS) are at increased risk of developing GDM. Today, GDM is diagnosed by oral glucose tolerance test (OGTT), a rather cumbersome test for the women and health care system. The objectives of this study were to investigate whether HbA1c in first trimester of pregnancy could be used as a screening test for GDM in first trimester and throughout pregnancy in order to reduce the number of OGTTs, and whether it could predict preeclampsia and macrosomia in women with PCOS. METHODS Post hoc analyses of data from 228 women from a prospective, randomised, multicenter study comparing metformin to placebo from first trimester to delivery. Fasting and 2-h plasma glucose were measured during a 75 g OGTT in first trimester, gestational week 19 and 32 as well as fasting plasma glucose in gestational week 36. GDM was diagnosed by WHO criteria from 1999 in first trimester and throughout pregnancy and by modified IADPSG criteria (i.e. lacking the 1-h plasma glucose value) in first trimester. The diagnostic accuracy was assessed by logistic regression and ROC curve analysis. RESULTS The area under the ROC curve for first trimester HbA1c for screening of GDM diagnosed by WHO criteria in first trimester was 0.60 (95 % CI 0.44-0.75) and 0.56 (95 % CI 0.47-0.65) for GDM diagnosed throughout pregnancy. Only 2.2 % (95 % CI 0.7-5.1 %) of the participants could have avoided OGTT. HbA1c was not statistically significantly associated with GDM diagnosed by modified IADPSG criteria in first trimester. However, first trimester HbA1c was statistically significantly associated with preeclampsia. Both HbA1c and GDM by WHO criteria in first trimester, but not by IADPSG, were negatively associated with birth weight. CONCLUSION First trimester HbA1c can not be used to exclude or predict GDM in women with PCOS, but it might be better to predict preeclampsia than the GDM diagnosis.
Collapse
Affiliation(s)
- Ingrid Hov Odsæter
- Department of Clinical Chemistry, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Arne Åsberg
- Department of Clinical Chemistry, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
| | - Eszter Vanky
- Department of Obstetrics and Gynecology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
- Department of Laboratory Medicine, Children's and Women's Health, Trondheim, Norway.
| | - Sven Magnus Carlsen
- Department of Endocrinology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
- Unit for Applied Clinical Research, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
| |
Collapse
|
10
|
Helseth R, Salvesen O, Stafne SN, Mørkved S, Salvesen KA, Carlsen SM. Gestational diabetes mellitus among Nordic Caucasian women: prevalence and risk factors according to WHO and simplified IADPSG criteria. Scandinavian Journal of Clinical and Laboratory Investigation 2014; 74:620-8. [PMID: 24980704 DOI: 10.3109/00365513.2014.928942] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is associated with both maternal and offspring adverse effects. The World Health Organization (WHO) has recently adopted novel GDM criteria. The aim of this study was to evaluate the former WHO and a simplified version of the new International Association for Diabetes in Pregnancy Study Group (IADPSG) criteria as to prevalence of and risk factors for GDM in a Nordic Caucasian population. METHODS A 75 g oral glucose tolerance test was performed in 687 women at 18-22 and 32-36 pregnancy weeks. GDM was defined according to the WHO criteria as fasting plasma glucose ≥ 7.0 mmol/L and/or 2-hour plasma glucose ≥ 7.8 mmol/L and by a simplified version of the IADPSG criteria as either fasting glucose ≥ 5.1 mmol/L and/or 2-h plasma glucose ≥ 8.5 mmol/L. One-hour glucose values were not available and were thus not included in the diagnosis of GDM by IADPSG. Prevalence of GDM during pregnancy and risk factors for GDM at 18-22 weeks were studied in retrospect according to each of the two criteria. RESULTS The total prevalence of GDM during pregnancy was 6.1% (42/687) for the WHO criteria and 7.4% (51/687) for the simplified IADPSG criteria. High maternal age and short stature were independently associated with WHO GDM. Maternal age, fasting insulin and no regular exercise at 18-22 pregnancy weeks associated with simplified IADPSG GDM. CONCLUSIONS Simplified IADPSG criteria moderately increase GDM prevalence compared with the WHO criteria. Risk factors for GDM differ with the diagnostic criteria used.
Collapse
Affiliation(s)
- Ragnhild Helseth
- Department of Internal Medicine, Drammen Hospital , Vestre Viken
| | | | | | | | | | | |
Collapse
|