Lilian C Mendoza1, Jürgen Harreiter2, David Simmons3,4, Gernot Desoye5, J M Adelantado6, Fabiola Juarez6, Ana Chico1,6,7, Roland Devlieger8,9, Andre van Assche8,9, Sander Galjaard8,9, Peter Damm10,11, Elisabeth R Mathiesen10,11, Dorte M Jensen12,13, Lise Lotte T Andersen12,13, Mette Tanvig12,13, Annunziata Lapolla14, Maria G Dalfra14, Alessandra Bertolotto15, Urszula Mantaj16, Ewa Wender-Ozegowska16, Agnieszka Zawiejska16, David Hill17, Judith G Jelsma18, Frank J Snoek19, Mireille N M van Poppel18,20, Christof Worda21, Dagmar Bancher-Todesca21, Alexandra Kautzky-Willer2,22, Fidelma P Dunne23, Rosa Corcoy1,6,7. 1. Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain. 2. Division of Endocrinology, Department of Medicine III, Gender Medicine Unit, Medical University of Vienna, Vienna, Austria. 3. Institute of Metabolic Science, Addenbrookes Hospital, Cambridge, UK. 4. Macarthur Clinical School, Western Sydney University, Sydney, Australia. 5. Department of Obstetrics and Gynecology, Medizinische Universitaet Graz, Graz, Austria. 6. Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. 7. CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, Zaragoza, Spain. 8. KU Leuven, Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Leuven, Belgium. 9. Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium. 10. Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen, Denmark. 11. Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. 12. Departments of Endocrinology, Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark. 13. Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark. 14. Universita Degli Studi di Padova, Padua, Italy. 15. Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy. 16. Division of Reproduction, Medical Faculty I, Poznan University of Medical Sciences, Poznan, Poland. 17. Recherche en Santé Lawson SA, St Gallen, Switzerland. 18. Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, the Netherlands. 19. Department of Medical Psychology, VU University Medical Centre and Academic Medical Centre, Amsterdam, the Netherlands. 20. Institute of Sport Science, University of Graz, Graz, Austria. 21. Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria. 22. Gender Medicine Institute, Gars am Kamp, Austria. 23. National University of Ireland, Galway, Ireland.
Abstract
OBJECTIVE: Risk factors are widely used to identify women at risk for gestational diabetes mellitus (GDM) without clear distinction by pregnancy period or oral glucose tolerance test (OGTT) time points. We aimed to assess the clinical risk factors for Hyperglycemia in pregnancy (HiP) differentiating by these two aspects. DESIGN AND METHODS: Nine hundred seventy-one overweight/obese pregnant women, enrolled in the DALI study for preventing GDM. OGTTs were performed at ≤19 + 6, 24-28 and 35-37 weeks (IADPSG/WHO2013 criteria). Women with GDM or overt diabetes at one time point did not proceed to further OGTTs. Potential independent variables included baseline maternal and current pregnancy characteristics. STATISTICAL ANALYSIS: Multivariate logistic regression. RESULTS: Clinical characteristics independently associated with GDM/overt diabetes were at ≤19 + 6 weeks, previous abnormal glucose tolerance (odds ratio (OR): 3.11; 95% CI: 1.41-6.85), previous GDM (OR: 2.22; 95% CI: 1.20-4.11), neck circumference (NC) (OR: 1.58; 95% CI: 1.06-2.36 for the upper tertile), resting heart rate (RHR, OR: 1.99; 95% CI: 1.31-3.00 for the upper tertile) and recruitment site; at 24-28 weeks, previous stillbirth (OR: 2.92; 95% CI: 1.18-7.22), RHR (OR: 3.32; 95% CI: 1.70-6.49 for the upper tertile) and recruitment site; at 35-37 weeks, maternal height (OR: 0.41; 95% CI: 0.20-0.87 for upper tertile). Clinical characteristics independently associated with GDM/overt diabetes differed by OGTT time point (e.g. at ≤19 + 6 weeks, NC was associated with abnormal fasting but not postchallenge glucose). CONCLUSION: In this population, most clinical characteristics associated with GDM/overt diabetes were non-modifiable and differed by pregnancy period and OGTT time point. The identified risk factors can help define the target population for future intervention trials.
OBJECTIVE: Risk factors are widely used to identify women at risk for gestational diabetes mellitus (GDM) without clear distinction by pregnancy period or oral glucose tolerance test (OGTT) time points. We aimed to assess the clinical risk factors for Hyperglycemia in pregnancy (HiP) differentiating by these two aspects. DESIGN AND METHODS: Nine hundred seventy-one overweight/obese pregnant women, enrolled in the DALI study for preventing GDM. OGTTs were performed at ≤19 + 6, 24-28 and 35-37 weeks (IADPSG/WHO2013 criteria). Women with GDM or overt diabetes at one time point did not proceed to further OGTTs. Potential independent variables included baseline maternal and current pregnancy characteristics. STATISTICAL ANALYSIS: Multivariate logistic regression. RESULTS: Clinical characteristics independently associated with GDM/overt diabetes were at ≤19 + 6 weeks, previous abnormal glucose tolerance (odds ratio (OR): 3.11; 95% CI: 1.41-6.85), previous GDM (OR: 2.22; 95% CI: 1.20-4.11), neck circumference (NC) (OR: 1.58; 95% CI: 1.06-2.36 for the upper tertile), resting heart rate (RHR, OR: 1.99; 95% CI: 1.31-3.00 for the upper tertile) and recruitment site; at 24-28 weeks, previous stillbirth (OR: 2.92; 95% CI: 1.18-7.22), RHR (OR: 3.32; 95% CI: 1.70-6.49 for the upper tertile) and recruitment site; at 35-37 weeks, maternal height (OR: 0.41; 95% CI: 0.20-0.87 for upper tertile). Clinical characteristics independently associated with GDM/overt diabetes differed by OGTT time point (e.g. at ≤19 + 6 weeks, NC was associated with abnormal fasting but not postchallenge glucose). CONCLUSION: In this population, most clinical characteristics associated with GDM/overt diabetes were non-modifiable and differed by pregnancy period and OGTT time point. The identified risk factors can help define the target population for future intervention trials.
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