TY - JOUR
T1 - Risk factors for hyperglycemia in pregnancy in the DALI study differ by period of pregnancy and OGTT time point
AU - Mendoza, Lilian C
AU - Harreiter, Jürgen
AU - Simmons, David
AU - Desoye, Gernot
AU - Adelantado, J M
AU - Juarez, Fabiola
AU - Chico, Ana
AU - Devlieger, Roland
AU - van Assche, Andre
AU - Galjaard, Sander
AU - Damm, Peter
AU - Mathiesen, Elisabeth R
AU - Jensen, Dorte M
AU - Andersen, Lise Lotte T
AU - Tanvig, Mette
AU - Lapolla, Annunziata
AU - Dalfra, Maria G
AU - Bertolotto, Alessandra
AU - Mantaj, Urszula
AU - Wender-Ozegowska, Ewa
AU - Zawiejska, Agnieszka
AU - Hill, David
AU - Jelsma, Judith G
AU - Snoek, Frank J
AU - van Poppel, Mireille N M
AU - Worda, Christof
AU - Bancher-Todesca, Dagmar
AU - Kautzky-Willer, Alexandra
AU - Dunne, Fidelma P
AU - Corcoy, Rosa
AU - DALI Core Investigator group
N1 - © 2018 European Society of Endocrinology.
PY - 2018/7
Y1 - 2018/7
N2 - 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.
AB - 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.
KW - Adult
KW - Blood Glucose/metabolism
KW - Body Height
KW - Body Size
KW - Diabetes, Gestational/epidemiology
KW - Exercise
KW - Fasting
KW - Female
KW - Gestational Age
KW - Glucose Intolerance/epidemiology
KW - Glucose Tolerance Test
KW - Healthy Diet
KW - Heart Rate
KW - Humans
KW - Hyperglycemia/epidemiology
KW - Motivational Interviewing
KW - Neck
KW - Obesity/epidemiology
KW - Odds Ratio
KW - Pregnancy
KW - Pregnancy Complications/epidemiology
KW - Randomized Controlled Trials as Topic
KW - Risk Factors
KW - Stillbirth/epidemiology
U2 - 10.1530/EJE-18-0003
DO - 10.1530/EJE-18-0003
M3 - Journal article
C2 - 29739812
SN - 0804-4643
VL - 179
SP - 39
EP - 49
JO - European Journal of Endocrinology
JF - European Journal of Endocrinology
IS - 1
ER -