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Rivista sulle Malattie del Sistema Endocrino
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Minerva Endocrinologica 2015 Dicembre;40(4):239-47
The new combination of risk factors determining a high risk of gestational diabetes mellitus
Popova P. V. 1, 2, Grineva E. N. 1, 2, Gerasimov A. S. 1, Kravchuk E. N. 1, Ryazantseva E. M. 3, Shelepova E. S. 4 ✉
1 Institution of Endocrinology, Almazov Federal Medical Research Centre, St Petersburg, Russia;
2 Department of Internal Diseases and Endocrinology, St Petersburg Pavlov State Medical University, St Petersburg, Russia;
3 Consulting and Diagnostic Centre, with the Out‑Patient Clinic UDPRF, St Petersburg, Russia;
4 Perinatology and Pediatrics Institute, Almazov Federal Medical Research Centre, St Petersburg, Russia
AIM: The aim of this study was to identify early markers of gestational diabetes mellitus (GDM) and to reveal the most significant of them.
METHODS: A total of 548 pregnant women were screened for GDM between weeks 24 and 28 of gestation, as defined by International Association of Diabetes In Pregnancy Study Groups (IADPSG) criteria, in a retrospective case-control study. First trimester maternal fasting glucose, anthropometric parameters and blood pressure were obtained from medical records. Classification Tree Method was used to identify combination of early pregnancy risk factors that predict the highest risk of the development of GDM in later pregnancy.
RESULTS: The combination of Body Mass Index (BMI) >38.6 kg/m² with, abdominal circumference >91.5 cm and fasting glucose >4.5 mmol/L was associated with a 13-fold increased risk of GDM as compared to women who do not have this combination of symptoms (OR 13.2 95% CI: 2.7-63.3, P<0.001). In women with BMI less than 38,6 kg/m ² the combination of fasting glucose >4.5 mmol/L, abdominal circumference >91.5 cm with the presence of polycystic ovary syndrome (PCOS) was associated with a 6-fold increased risk of GDM as compared with women who do not have this combination of symptoms (OR=7.6, 95% CI: 1.9-30.02, P=0.003).
CONCLUSION: A higher BMI, abdominal circumference, fasting glycemia in the first trimester of pregnancy and the presence of PCOS predict increased GDM risk. Taking these combinations into consideration may facilitate identification of women at particular risk for GDM.