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Ezazi Bojnordi, T., Hantoushzadeh, S., Sabzevary, M., & Heidari, Z. (2021). A case–control study to predict the risk of gestational diabetes mellitus by initial fasting blood sugar or past gestational history. International Journal of Reproductive BioMedicine (IJRM), 19(4), 381–390. https://doi.org/10.18502/ijrm.v19i4.9064
https://doi.org/10.18502/ijrm.v19i4.9064
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Tahmineh Ezazi Bojnordi
Tahmineh Ezazi Bojnordi
Department of Obstetrics and Gynecology, Loghman Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Sedigheh Hantoushzadeh
Sedigheh Hantoushzadeh
Department of Gynecology and Obstetrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Masomeh Sabzevary
Masomeh Sabzevary
Department of Gynecology and Obstetrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Zahra Heidari
Zahra Heidari
Department of Histology, Genetic of Non-communicable Diseases Research Center, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
Published Date
- Apr 22, 2021
A case–control study to predict the risk of gestational diabetes mellitus by initial fasting blood sugar or past gestational history
Abstract
Background: Gestational diabetes mellitus (GDM) deserves proper prevention, diagnosis, and management due to healthcare implications from both maternal and fetal concerns.
Objective: To evaluate the rate and investigate the risk factors for developing GDM.
Materials and Methods: In this case-control, universal screening for GDM between 24 and 28 wk of gestation was performed in 613 pregnant women attending a prenatal clinic in Tehran who were followed-up until delivery between March 2017 to March 2018. Of the 613 women, 143 had GDM and 470 had normal glucose tolerance test as the primary diagnosis. Some GDM risk factors were compared in two groups.
Results: Impaired glucose tolerance test was detected in 143 (23.3%) patients. Prevalence of GDM was higher in the first-trimester fasting blood sugar (FBS) > 90 qmg/dl group (p < 0.001). Comparison of the GDM and the normal glucose tolerance test groups demonstrated significant differences in maternal age, first-trimester FBS, third-trimester vitamin D level, maternal platelet count, maternal body mass index (BMI) (before 12 wk of gestation), weight gain during pregnancy, and the history of gestational complications in previous pregnancy (p < 0.01). In logistic regression, GDM was independently associated with older maternal age, higher first-trimester FBS, the history of gestational complications in previous pregnancy, lower third-trimester vitamin D level, and higher maternal platelet count (p < 0.01).
Conclusion: Both patients with higher initial FBS and the history of gestational complications in previous pregnancy should be considered high risk for GDM and screened earlier.
Key words: Diabetes Mellitus, Gestational, Blood glucose, Risk factor.
References
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[18] Karcaaltincaba D, Kandemir O, Yalvac S, Guvendag-Guven S, Haberal A. Prevalence of gestational diabetes mellitus and gestational impaired glucose tolerance in pregnant women evaluated by National Diabetes Data Group and Carpenter and Coustan criteria. Int J Gynaecol Obstet 2009; 106: 246–249.
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[26] Wang C, Zhu W, Wei Y, Feng H, Su R, Yang H. Exercise intervention during pregnancy can be used to manage weight gain and improve pregnancy outcomes in women with gestational diabetes mellitus. BMC Pregnancy Childbirth 2015; 15: 255–262.
[27] Burris HH, Rifas-Shiman SL, Kleinman K, Litonjua AA, Huh SY, Rich-Edwards JW, et al. Vitamin D deficiency in pregnancy and gestational diabetes mellitus. Am J Obstetr Gynecol 2012; 207: 182: e1–e8.
[28] Soheilykhah S, Mojibian M, Rashidi M, Rahimi-Saghand S, Jafari F. Maternal vitamin D status in gestational diabetes mellitus. Nutr Clin Pract 2010; 25: 524–527.
[29] Clifton−Bligh R, McElduff P, McElduff A. Maternal vitamin D deficiency, ethnicity and gestational diabetes. Diabet Med 2008; 25: 678–684.
[30] Zhang C, Qiu C, Hu FB, David RM, Van Dam RM, Bralley A, et al. Maternal plasma 25-hydroxyvitamin D concentrations and the risk for gestational diabetes mellitus. PLoS One 2008; 3: e3753–e3758.
[31] Aktulay A, Engin-Ustun Y, Ozkan MS, Erkaya S, Kara M, Kaymak O, et al. Gestational diabetes mellitus seems to be associated with inflammation. Acta Clin Croat 2015; 54: 475–478.
[32] Liu BY, Jian YL, Zhong M, Yu YH, Wang Q, Zhang J. [Value of coagulation function and fibrinolytic system assessment in patients with gestational diabetes mellitus]. Nan Fang Yi Ke Da Xue Xue Bao 2007; 27: 35–37.
[33] Erikçi AA, Muhçu M, Dündar Ö, Öztürk A. Could mean platelet volume be a predictive marker for gestational diabetes mellitus? Hematology 2008; 13: 46–48.
[2] Buchanan TA, Xiang AH. Gestational diabetes mellitus. J Clin Invest 2005; 115: 485–491.
[3] Jafari-Shobeiri M, Ghojazadeh M, Azami-Aghdash S, Naghavi-Behzad M, Piri R, Pourali-Akbar Y, et al. Prevalence and risk factors of gestational diabetes in Iran: A systematic review and meta-analysis. Iran J Public Health 2015; 44: 1036–1044.
[4] Shahbazian H, Nouhjah S, Shahbazian N, Jahanfar S, Latifi SM, Aleali A, et al. Gestational diabetes mellitus in an Iranian pregnant population using IADPSG criteria: Incidence, contributing factors and outcomes. Diabetes Metab Syndr 2016; 10: 242–246.
[5] Cypryk K, Szymczak W, Czupryniak L, Sobczak M, Lewinski A. Gestational diabetes mellitus-An analysis of risk factors. Endokrynologia Polska 2008; 59: 393–397.
[6] Phelan S. Windows of opportunity for lifestyle interventions to prevent gestational diabetes mellitus. Am J Perinatol 2016; 33: 1291–1299.
[7] Di Cianni G, Volpe L, Lencioni C, Miccoli R, Cuccuru I, Ghio A, et al. Prevalence and risk factors for gestational diabetes assessed by universal screening. Diabetes Res Clin Pract 2003; 62: 131–137.
[8] Li P, Yin Y, Lin S, Cui J, Zhou S, Li L, et al. Utility of pregestational body mass index and initial fasting plasma glucose in predicting gestational diabetes mellitus. Am J Med Sci 2016; 351: 420–425.
[9] Erem C, Kuzu UB, Deger O, Can G. Prevalence of gestational diabetes mellitus and associated risk factors in Turkish women: The Trabzon GDM Study. Arch Med Sci 2015; 11: 724–735.
[10] Lee J, Ouh YT, Ahn KH, Hong SC, Oh MJ, Kim HJ, et al. Preeclampsia: A risk factor for gestational diabetes mellitus in subsequent pregnancy. PLoS One 2017; 12: 1– 8.
[11] Riskin-Mashiah Sh, Damti A, Younes G, Auslender R. First trimester fasting hyperglycemia as a predictor for the development of gestational diabetes mellitus. Eur J Obstet Gynecol Reprod Biol 2010; 152: 163–167.
[12] Association AD. Diagnosis and classification of diabetes mellitus. Diabetes Care 2010; 33: S62–S69.
[13] Cunningham F, Leveno K, Bloom S, Spong CY, Dashe J. Williams obstetrics. 24 Ed. USA: Mcgraw-hill; 2014.
[14] Pridjian G, Benjamin TD. Update on gestational diabetes. Obstet Gynecol Clin North Am 2010; 37: 255–267.
[15] Reece EA, Leguizamon G, Wiznitzer A. Gestational diabetes: The need for a common ground. Lancet 2009; 373: 1789–1797.
[16] Yang S, Shi FT, Leung PCK, Huang HF, Fan J. Low thyroid hormone in early pregnancy is associated with an increased risk of gestational diabetes mellitus. J Clin Endocrinol Metab 2016; 101: 4237–4243.
[17] Keshavarz M, Cheung NW, Babaee GhR, Kalalian Moghadam H, Ajami ME, Shariati M. Gestational diabetes in Iran: Incidence, risk factors and pregnancy outcomes Diabetes Res Clin Pract 2005; 69: 279–286.
[18] Karcaaltincaba D, Kandemir O, Yalvac S, Guvendag-Guven S, Haberal A. Prevalence of gestational diabetes mellitus and gestational impaired glucose tolerance in pregnant women evaluated by National Diabetes Data Group and Carpenter and Coustan criteria. Int J Gynaecol Obstet 2009; 106: 246–249.
[19] Torloni MR, Betran AP, Horta BL, Nakamura MU, Atallah AN, Moron AF, et al. Prepregnancy BMI and the risk of gestational diabetes: A systematic review of the literature with meta-analysis. Obes Rev 2009; 10: 194–203.
[20] Chu SY, Callaghan WM, Kim SY, Schmid CH, Lau J, England LJ, et al. Maternal obesity and risk of gestational diabetes mellitus. Diabetes Care 2007; 30: 2070–2076.
[21] Athukorala C, Rumbold AR, Willson KJ, Crowther CA. The risk of adverse pregnancy outcomes in women who are overweight or obese. B BMC Pregnancy Childbirth 2010; 10: 56–64.
[22] Mao L, Ge X, Xu Y, Huang K, Pan W, Zhou S, et al. [Pregestational body mass index, weight gain during first half of pregnancy and gestational diabetes mellitus: A prospective cohort study]. Zhonghua Liu Xing Bing Xue Za Zhi 2015; 36: 416–420.
[23] Liu Z, Ao D, Yang H, Wang Y. Gestational weight gain and risk of gestational diabetes mellitus among Chinese women. Chin Med J 2014; 127: 1255–1260.
[24] Carreno CA, Clifton RG, Hauth JC, Myatt L, Roberts JM, Spong CY, et al. Excessive early gestational weight gain and risk of gestational diabetes mellitus in nulliparous women. Obstet Gynecol 2012; 119: 1227–1233.
[25] Simmons D, Devlieger R, van Assche A, Jans G, Galjaard S, Corcoy R, et al. Effect of physical activity and/or healthy eating on GDM risk: The DALI Lifestyle Study. J Clin Endocrinol Metab 2017; 102: 903–913.
[26] Wang C, Zhu W, Wei Y, Feng H, Su R, Yang H. Exercise intervention during pregnancy can be used to manage weight gain and improve pregnancy outcomes in women with gestational diabetes mellitus. BMC Pregnancy Childbirth 2015; 15: 255–262.
[27] Burris HH, Rifas-Shiman SL, Kleinman K, Litonjua AA, Huh SY, Rich-Edwards JW, et al. Vitamin D deficiency in pregnancy and gestational diabetes mellitus. Am J Obstetr Gynecol 2012; 207: 182: e1–e8.
[28] Soheilykhah S, Mojibian M, Rashidi M, Rahimi-Saghand S, Jafari F. Maternal vitamin D status in gestational diabetes mellitus. Nutr Clin Pract 2010; 25: 524–527.
[29] Clifton−Bligh R, McElduff P, McElduff A. Maternal vitamin D deficiency, ethnicity and gestational diabetes. Diabet Med 2008; 25: 678–684.
[30] Zhang C, Qiu C, Hu FB, David RM, Van Dam RM, Bralley A, et al. Maternal plasma 25-hydroxyvitamin D concentrations and the risk for gestational diabetes mellitus. PLoS One 2008; 3: e3753–e3758.
[31] Aktulay A, Engin-Ustun Y, Ozkan MS, Erkaya S, Kara M, Kaymak O, et al. Gestational diabetes mellitus seems to be associated with inflammation. Acta Clin Croat 2015; 54: 475–478.
[32] Liu BY, Jian YL, Zhong M, Yu YH, Wang Q, Zhang J. [Value of coagulation function and fibrinolytic system assessment in patients with gestational diabetes mellitus]. Nan Fang Yi Ke Da Xue Xue Bao 2007; 27: 35–37.
[33] Erikçi AA, Muhçu M, Dündar Ö, Öztürk A. Could mean platelet volume be a predictive marker for gestational diabetes mellitus? Hematology 2008; 13: 46–48.