Association between levels of aquaporin 3 in the placenta and adiponectin in the umbilical cord blood with gestational diabetes mellitus and pregnancy outcome

To investigate the expression of aquaporin 3 (AQP3) in placenta and fetal membranes and the level of adiponectin (ADP) in the umbilical cord blood of severe preeclampsia and to analyze the relationship between the 2 proteins and severe preeclampsia, 60 pregnant women with severe preeclampsia were recruited as the case group and another group of 60 normal pregnant women in the same gestation period were selected as the control. After parturition, the transcriptional levels of AQP3 mRNA in placenta and fetal membranes were evaluated with RT-PCR. The expressions of AQP3 protein in the placenta and fetal membranes were determined by immunohistochemistry and Western blot. Meanwhile, the expression of ADP in umbilical artery blood was detected by ELISA. The content of triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and LDL-C/high-density lipoprotein cholesterol in the case group was significantly higher than that in the control group. Multivariate logistic regression analysis showed that the level of TG was related to the onset of severe preeclampsia (OR 2.589). The relative expression of AQP3 mRNA and expression of AQP3 protein in placenta tissue of the case group were significantly lower than those of the control group, whereas in fetal membranes, they were significantly higher. The results of ELISA showed that the level of ADP in umbilical cord blood of neonates in the case group increased remarkably compared with that of the control group.

Objective Through the determination of pregnancy gestational diabetes mellitus (GDM) lactating women colostrum and 90 day mature milk adiponectin (Adiponectin), Apelin, baby vascular endothelial growth factor-1 (VEGF-R1) receptor levels, to detect the correlation between maternal serum levels of lipid and glucose metabolism abnormality and children’s body mass. Methods Prospective randomized controlled trials were used from December 2014 to June 2015, GDM pregnant women and their newborns for GDM group (20 pairs) were selected; in addition to select obstetrical period singleton term delivery, and no pregnancy complications of healthy pregnant women and newborns as control group (n=25). The changes of Adiponectin and apelin levels in maternal colostrum and mature milk were detected, and the levels of VEGF-R1 in umbilical cord blood were compared, and the correlation between Adiponectin, apelin, VEGF-R1 and the quality of children’s body was analyzed. Results In GDM group , the Adiponectin levels in colostrum and mature milk were significant lower than those of the control group (P 0.05). Adiponectin and neonatal umbilical cord blood VEGF-R1 were positively correlated with neonatal body mass in GDM breast feeding women. However, Apelin was not related to the quality of newborn babies in the breast milk of GDM during lactation. Conclusions In pregnant women with abnormal glucose metabolism, obesity in pregnancy and prenatal has remarkable effects on their children’s body mass, and its level is closely correlated with Adiponectin, apelin in the mother’s milk and baby’s own VEGF-R1. Key words: Gestational diabetes mellitus; Adiponectin; Apelin; Vascular endothelial growth factor-1; Body mass in children

The aim of this study was to evaluate how resistin and adiponectin (ApN) are involved in maternal energy metabolism and foetal growth. A cross-sectional study. Resistin and ApN were measured in 30 healthy nonpregnant women, 73 pregnant women [10-41 weeks of gestation; 18 with gestational diabetes mellitus (GDM), five with pregnancy-induce hypertension (PIH), nine with pre-eclampsia (PE), eight with chronic hypertension (CH) and 33 normal] and 40 foetal samples (20-41 weeks of gestation; 18 from GDM mothers and 22 from normal mothers). Resistin levels were significantly higher in normal pregnant women than in nonpregnant controls (13.7 +/- 2.1 vs. 6.3 +/- 1.6 ng/ml; P < 0.005) and showed a negative correlation with gestational age (P < 0.0001, r = -0.7). Only women with PE presented resistin levels significantly lower than normotensive women of the same gestational age (8.2 +/- 1.2 vs. 17.9 +/- 4.3 ng/ml; P < 0.005). ApN levels, although similar in normal pregnant women to those in nonpregnant controls, were significantly lower in women with GDM (37-41 weeks; 5.2 +/- 0.5 vs. 8.2 +/- 0.8 mg/l; P < 0.0001) and PE (20-37 weeks; 5.0 +/- 0.7 vs. 9.5 +/- 0.7 mg/l; P = 0.008) than those found in normal women matched for gestational age. Resistin was detected in the umbilical venous blood in foetuses from 20 to 41 weeks of gestation. In all newborns, both resistin and ApN levels were significantly higher than those recorded in adult life and did not correlate with maternal levels (P = ns, r = 0.03 for resistin and P = ns, r = -0.3 for ApN). Foetuses from diabetic mothers had ApN significantly lower than normal foetuses (26.8 +/- 2.6 vs. 37.5 +/- 3.5 mg/l; P = 0.02), while resistin levels were similar (17.3 +/- 3.7 vs. 18.2 +/- 1.5 ng/ml; P = ns). The secretion pattern of ApN in normal and complicated pregnancies strongly suggests an involvement of ApN in insulin resistance during gestation, while resistin seems to have a minor role. Moreover, the detection of high levels of resistin and ApN in cord blood during gestation is consistent with a regulatory action of these adipokines on tissue differentiation and foetal growth.

Gestational diabetes mellitus (GDM) is linked to higher newborn weight and an increased risk of macrosomia. The newborn single-nucleotide polymorphism (SNP) of the ADIPOQ gene rs266729 is linked to a higher birth weight of the offspring of healthy pregnant women. This study aims to evaluate the relationship between newborn ADIPOQ rs266729 polymorphism, cord blood adiponectin, maternal glycemic and lipid metabolism, and maternal adiponectin levels at 24 to 28 weeks of gestation (WG) and at birth and its impact on newborn weight in a cohort of GDM mothers. This study involved 71 women diagnosed with GDM and 142 control pregnant women. The ADIPOQ (rs266729) gene polymorphisms were genotyped using TaqMan real-time PCR analysis. Maternal and cord blood adiponectin levels were measured using human total adiponectin ELISA kits. We performed a Pearson correlation analysis to identify significant correlations between maternal metabolic parameters and adiponectin levels at 24-28 WG and birth and the weight of newborns. A logistic regression analysis was also conducted to identify potential macrosomia predictors. We found no significant differences in the distribution of the allele (C, G) (p = 0.82) and genotype (CC, CG, GG) (p = 0.46) of APIPOQ rs266729 among normoponderal and macrosomic newborns from the GDM mothers group. Maternal fasting glucose at 24-28 WG was higher in the GDM mothers who gave birth to macrosomic newborns (106 ± 17 vs. 93 ± 10 mg/dL, p < 0.0001). Adiponectin levels in the cord blood of newborns from mothers with GDM were lower than those in newborns from control mothers (p < 0.0001). In correlation analysis, we identified a weak positive correlation between the newborn weight of GDM mothers and cord blood adiponectin (r = 0.262), maternal fasting glucose level at 24-28 WG (r = 0.288), and maternal adiponectin level at birth (0.334). Multivariate logistic regression, after adjusting for confounders, revealed that maternal fasting glucose levels at 24-28 WG had an OR of 11.59, and cord blood adiponectin levels had an OR of 30.31 for macrosomia. The preliminary findings of our pilot study suggest that in the gestational diabetes mellitus group, the ADIPOQ rs266729 polymorphism in newborns is not associated with a higher birth weight, maternal fasting glucose levels between 24 and 28 WG were a predictor for macrosomia, and cord blood adiponectin levels were lower than those from control mothers. Further large-scale studies are needed to confirm our findings.

PurposeTo investigate and identify first-trimester fasting plasma glucose (FPG) is related to gestational diabetes mellitus (GDM) and other adverse pregnancy outcomes in Shenzhen population.MethodsWe used data of 48,444 pregnant women that had been retrospectively collected between 2017 and 2019. Logistic regression analysis was used to evaluated the associations between first-trimester FPG and GDM and adverse pregnancy outcomes, and used to construct a nomogram model for predicting the risk of GDM. The performance of the nomogram was evaluated by using ROC and calibration curves. Decision curve analysis (DCA) was used to determine the clinical usefulness of the first-trimester FPG by quantifying the net benefits at different threshold probabilities.ResultsThe mean first-trimester FPG was 4.62 ± 0.42 mmol/L. A total of 6998 (14.4%) pregnancies developed GDM.489(1.01%) pregnancies developed polyhydramnios, the prevalence rates of gestational hypertensive disorder (GHD), cesarean section, primary cesarean section, preterm delivery before 37 weeks (PD) and dystocia was 1130 (2.33%), 20,426 (42.16%), 7237 (14.94%), 2386 (4.93%), and 1865 (3.85%), respectively. 4233 (8.74%) of the newborns were LGA, and the number of macrosomia was 2272 (4.69%), LBW was 1701 (3.51%) and 5084 (10.49%) newborns had admission to the ICU, which all showed significances between GDM and non-GDM groups (all P < 0.05). The univariate analysis showed that first-trimester FPG was strongly associated with risks of outcomes including GDM, cesarean section, macrosomia, GHD, primary cesarean section, and LGA (all OR > 1, all P < 0.05), furthermore, the risks of GDM, primary cesarean section, and LGA was increasing with first-trimester FPG as early as it was at 4.19–4.63 mmol/L. The multivariable analysis showed that the risks of GDM (ORs for FPG 4.19–4.63, 4.63–5.11 and 5.11–7.0 mmol/L were 1.137, 1.592, and 4.031, respectively, all P < 0.05) increased as early as first-trimester FPG was at 4.19–4.63 mmol/L, and first-trimester FPG which was also associated with the risks of cesarean section, macrosomia and LGA (OR for FPG 5.11–7.0 mmol/L of cesarean section: 1.128; OR for FPG 5.11–7.0 mmol/L of macrosomia: 1.561; OR for FPG 4.63–5.11 and 5.11–7.0 mmol/L of LGA: 1.149 and 1.426, respectively, all P < 0.05) and with its increasing, the risks of LGA increased. Furthermore, the nomogram had a C-indices 0.771(95% CI: 0.763~0.779) and 0.770(95% CI:0.758~0.781) in training and testing validation respectively, which showed an acceptable consistency between the observed, validation and nomogram-predicted probabilities, the DAC curve analysis indicated that the nomogram had important clinical application value for GDM risk prediction.ConclusionsFPG in the first trimester was an independent risk factor for GDM which can be used as a screening test for identifying pregnancies at risk of GDM and adverse pregnancy outcomes.

Leptin and adiponectin are adipocyte-secreted hormones that regulate energy homeostasis and metabolism. Because their roles in the neonatal period and in early childhood are poorly understood, we aimed in this prospective cohort study to determine the extent to which umbilical cord blood leptin and adiponectin concentrations predict measures of adiposity and growth at 3 years of age. We studied 588 children participating in the prospective prebirth cohort study Project Viva. We examined associations of cord blood leptin and adiponectin levels with weight changes during the first 6 months of life, 3-year circulating leptin and adiponectin concentrations, and the following adiposity-related outcomes at 3 years of age: BMI z score, height-for-age z score, and sums of triceps and subscapular skinfold thicknesses to represent overall adiposity, as well as subscapular/triceps skinfold ratio to represent central adiposity. Cord blood leptin and adiponectin were each directly associated with the duration of gestation and birth weight for gestational age z scores. Cord blood leptin levels were negatively associated with change in weight-for-length, weight-for-age, and length-for-age z scores between birth and 6 months of age. Similarly, cord blood adiponectin was negatively associated with change in weight-for-length and weight-for-age z scores. After adjusting for several maternal and child factors related to obesity, each 10 ng/mL increment of cord blood leptin was associated with a reduction in BMI z score and higher leptin levels at 3 years but not with skinfold thicknesses. Each 10 microg/mL increment of cord blood adiponectin was positively associated with a higher subscapular skinfold thickness/triceps skinfold thickness ratio at 3 years. Lower cord blood leptin levels are associated with smaller size at birth but more pronounced weight gain in the first 6 months of life and higher BMI at 3 years of age. Cord blood adiponectin levels are also directly associated with birth weight for gestational age, inversely associated with weight gain in the first 6 months of life, and predict an increase in central adiposity at age 3 years.

ObjectiveTo examine the expression levels of miR-144-3p in the plasma of patients with gestational diabetes mellitus (GDM) and to construct a nomogram for predicting and evaluating factors influencing adverse pregnancy outcomes (APO) in GDM based on plasma miR-144-3p levels.MethodsThis study included 442 pregnant women, comprising 216 diagnosed with GDM (GDM group) and 226 with normal glucose tolerance (NGT group). Plasma miR-144-3p levels in both groups were measured using reverse transcription real-time polymerase chain reaction (RT-qPCR). The diagnostic performance of plasma miR-144-3p for GDM was assessed by receiver operating characteristic (ROC) curve analysis. During pregnancy, the GDM group was followed, and outcomes were categorized into two groups: 132 with favorable pregnancy outcomes (FPO) and 84 with APO. A random number table method was applied to divide the GDM group into a training set (n=151) and a validation set (n=65) using a 7:3 ratio. Differences in variables across pregnancy outcome subgroups in the training set were examined. Univariate and multivariate logistic regression analyses were performed to identify risk factors for APO in GDM. Based on these factors, a nomogram prediction model was developed to estimate the risk of APO in GDM. The model’s performance was evaluated using area under the curve (AUC) analysis, calibration curve analysis, and decision curve analysis (DCA).ResultsThe expression of miR-144-3p was significantly higher in the GDM group than in the NGT group (p < 0.05). miR-144-3p showed an AUC of 0.877, with a sensitivity of 81.09% and a specificity of 91.20% for diagnosing GDM. No statistically significant differences were observed in general clinical characteristics between the training and validation sets. In the training set, gestational weight gain (GWG), the number of OGTT abnormalities, glycaemic control (GC), and miR-144-3p expression varied significantly between the APO and FPO subgroups (p < 0.05). Multivariate logistic regression analysis identified increased GWG, the number of OGTT abnormalities, poor GC, and higher miR-144-3p levels as independent risk factors for APO in GDM. The AUC of the nomogram based on these variables was 0.881 in the training set and 0.855 in the validation set. Calibration curves indicated good agreement between predicted and actual outcomes in both sets. The DCA showed a clear net clinical benefit and stable predictive utility.ConclusionElevated plasma miR-144-3p levels in pregnant women with GDM may contribute to the occurrence of APO. The number of OGTT abnormalities and glycaemic control were also identified as independent risk factors. A nomogram incorporating miR-144-3p and these clinical indicators displays strong predictive accuracy and provides a practical tool for assessing APO risk in GDM.

Early diagnosis of gestational diabetes mellitus (GDM) reduces the risk of adverse perinatal and maternal outcomes. At present, the value of serum adiponectin (ADP) and pregnancy-associated plasma protein A (PAPP-A) in clinical practice for the diagnosis of GDM in early pregnancy is unclear. To investigate the predictive value of serum ADP and PAPP-A in GDM. The electronic medical record data of all pregnant women from Zhongshan People’s Hospital from 2018 to 2021 were retrospectively collected and divided into GDM group and control group according to whether GDM occurred. ADP and PAPP-A levels of the 2 groups were detected in early pregnancy, and the related factors of GDM were analyzed by binary logistic regression analysis. Receiver operating characteristic (ROC) curves of ADP and PAPP-A in predicting GDM in the early pregnancy were plotted and their clinical predictive value was analyzed. The significance level for all statistical tests is 0.05. Compared with the non-GDM group, the ADP of the GDM group was significantly lower than that of the non-GDM group [(8.19 ± 2.24) vs. (10.04 ± 2.73)]mg/L, the difference between groups was statistically significant (P < .05), and the multiple of median (MoM) of PAPP-A was significantly lower than that of the non-GDM group (1.13 ± 0.52) versus (1.45 ± 0.61) (P < .05). Binary logistic regression analysis showed that elevated serum ADP and PAPP-A levels were negatively correlated with the subsequent development of GDM [odds ratio (OR) 95% confidence interval (95% CI)] was 0.626 (0.536, 0.816), 0.934 (0.908, 0.961), respectively, P < .05.ROC curve analysis showed that the sensitivity and specificity of ADP and PAPP-A in predicting gestational diabetes were79.1% and 58.6%, respectively, 92.7% and 73.1%, and respectively. The area under curve (AUC) is 0.755 for ADP and 0.770 for PAPP-A. The AUC of the combined detection was 0.867, both of which were higher than that of single index diagnosis, and the sensitivity and specificity of the combined detection were 0.958 and 0.853, respectively. In summary, PAPP-A and ADP levels are independent related factors affecting the occurrence of GDM. The combined detection of PAPP-A and ADP should be utilized in diagnosing GDM to improve pregnancy outcomes for pregnant women.

ObjectiveBoth of the above studies aimed to evaluate whether or not low levels of 25-hydroxyvitamin D in pregnancy were associated with an increased risk of developing GDM.The Parlea study measured vitamin D levels in the first trimester between weeks 15 and 18, while the Burris study tested for vitamin D levels during the second trimester between weeks 26 and 28.

Aquaporin 3 (AQP3) and phospholipase D2 (PLD2) are abnormally expressed and/or localized in squamous cell carcinoma (SCC). AQP3 transports glycerol to PLD2 for the synthesis of lipid second messenger, which can mediate the effect of the AQP3/PLD2 signaling module in the regulation of keratinocyte proliferation and differentiation. However, the role of the AQP3/PLD2 signaling module in the pathogenesis of SCC remains to be fully elucidated. In the present study, the expression levels of AQP3 and PLD2 in tissue samples were examined using immunohistochemistry, it was found that the expression levels of AQP3 and PLD2 in tissue samples of actinic keratosis (AK), Bowen's disease (BD) and SCC were significantly increased. AQP3 small interfering RNA (siRNA) and PLD2 siRNA were constructed and used for transfection into the human A431 SCC cell line, and their anticancer effect on SCC was examined. The mRNA expression and protein expression levels of AQP3 and PLD2 were significantly downregulated following siRNA transfection. AQP3 siRNA and PLD2 siRNA inhibited the proliferation and promoted the apoptosis of A431 cells. Taken together, the findings of the present study suggested that increased levels of AQP3 and PLD2 were correlated with tumor progression and development in SCC. AQP3 siRNA and PLD2 siRNA significantly downregulated the mRNA and protein levels of AQP3 and PLD2 in the A431 cells; inhibiting proliferation and promoting apoptosis in vitro. The concomitant effects of AQP3/PLD2 signaling by inhibiting the expression of siRNA may be important for the treatment of SCC in the future.

Hypoxic ischemic encephalopathy (HIE) is a serious condition which results in neonatal morbidity and mortality. Early prediction of HIE especially in the first six hours of birth leads to early treatment with better prognosis. The aim of this study was to compare the concentrations of leptin, adiponectin, and erythropoietin between normal neonates and those with HIE for the possible use of these markers for assessment of the degree of HIE and as markers for early prediction of HIE. This study was carried out on 50 appropriate for gestational age (AGA) neonates with HIE born in Tanta University Hospital during the period from June 2016 to March 2018 (Group I). This study also included 50 appropriate for gestational age (AGA) normal neonates not suffering from any complications and matched with group I in age and sex as a control group (Group II). For all neonates in both groups, the following were done: Complete prenatal, natal, and postnatal history, assessment of APGAR score at 5 and 10 minutes, complete clinical examination with special account on clinical evidence of encephalopathy including hypotonia, abnormal oculomotor or pupillary movements, weak or absent suckling, apnea, hyperpnea, or seizures, measurement of cord blood gases and measurement of serum erythropoietin, leptin and adiponectin levels by ELISA immediately after birth. There were no significant differences between Group I and Group II regarding gestational age, male to female ratio, mode of delivery, and weight while there were significant differences regarding Apgar score at 1 and 5 minutes with significantly lower Apgar score at 1 and 5 minutes in group I compared with Group II. There were significantly lower cord blood PH and adiponectin level and significantly higher cord blood Leptin and erythropoietin in group I compared with group II. There were significant differences between cord blood adiponectin, leptin, erythropoietin, and PH in different degrees of HIE with significantly lower cord blood adiponectin and PH and significantly higher cord blood leptin and erythropoietin in severe degree of hypoxia compared with moderate degree and in moderate degree compared with mild degree of hypoxia. There was a significant positive correlation between cord blood erythropoietin and leptin and a significant negative correlation between cord blood erythropoietin and both adiponectin and PH in studied neonates with hypoxia. ROC curve showed that EPO had the best sensitivity and specificity followed by leptin then adiponectin while the PH had the least sensitivity and specificity as early predictors of hypoxic neonates. Neonates with HIE had lower cord blood PH and adiponectin levels and higher leptin and erythropoietin levels than normal healthy neonates at birth and during the early postnatal period. The significant differences between cord blood erythropoietin, leptin, and adiponectin between neonates with hypoxia compared with normal neonates may arouse our attention about the use of these markers in the cord blood as early predictors of neonatal HIE which can lead early treatment and subsequently better prognosis.

BackgroundCord blood leptin and adiponectin are adipokines known to be associated with birth weight and overall infant adiposity. However, few studies have investigated their associations with abdominal adiposity in neonates. We examined maternal factors associated with cord blood leptin and adiponectin, and the association of these adipokines with neonatal adiposity and abdominal fat distribution measured by magnetic resonance imaging (MRI) in an Asian mother–offspring cohort.MethodsGrowing Up in Singapore Towards healthy Outcomes (GUSTO), is a prospective mother–offspring birth cohort study in Singapore. Cord blood plasma leptin and adiponectin concentrations were measured using Luminex and Enzyme-Linked Immunosorbent Assay respectively in 816 infants. A total of 271 neonates underwent MRI within the first 2-weeks after delivery. Abdominal superficial (sSAT), deep subcutaneous (dSAT), and intra-abdominal (IAT) adipose tissue compartment volumes were quantified from MRI images. Multivariable regression analyses were performed.ResultsIndian or Malay ethnicity, female sex, and gestational age were positively associated with cord blood leptin and adiponectin concentrations. Maternal gestational diabetes (GDM) positively associated with cord blood leptin concentrations but inversely associated with cord blood adiponectin concentrations. Maternal pre-pregnancy body mass index (BMI) showed a positive relationship with cord blood leptin but not with adiponectin concentrations. Each SD increase in cord blood leptin was associated with higher neonatal sSAT, dSAT and IAT; differences in SD (95% CI): 0.258 (0.142, 0.374), 0.386 (0.254, 0.517) and 0.250 (0.118, 0.383), respectively. Similarly, each SD increase in cord blood adiponectin was associated with higher neonatal sSAT and dSAT; differences in SD (95% CI): 0.185 (0.096, 0.274) and 0.173 (0.067, 0.278), respectively. The association between cord blood adiponectin and neonatal adiposity was observed in neonates of obese mothers only.ConclusionsCord blood leptin and adiponectin concentrations were associated with ethnicity, maternal BMI and GDM, sex and gestational age. Both adipokines showed positive association with neonatal abdominal adiposity.

Gestational diabetes mellitus (GDM) is an emerging public health concern in low and middle-income countries, including Nigeria, because of the associated pregnancy complications, increased healthcare costs and long-term health sequelae among women of reproductive age and their offspring. We determined the cumulative incidence, risk factors and pregnancy outcomes of GDM in Ibadan, Nigeria. Prospective cohort study. Ibadan, Southwest Nigeria. 721 pregnant women from the Ibadan Pregnancy Cohort Study participated in the one-step 75 g-oral glucose tolerance test at 24-28 weeks' gestation. The primary outcome of the study is the cumulative incidence of GDM. GDM was diagnosed according to the International Association of Diabetes and Pregnancy Study Groups criteria. Secondary outcomes were pregnancy outcomes, which included modes of delivery (CS, spontaneous vaginal delivery), macrosomia (birth weight ≥4.0 kg), gestational age at delivery and birth asphyxia. The risk factors (exposures) examined included sociodemographic, obstetric, clinical, behavioural and lifestyle factors. Bivariate and multivariate Log-binomial regression models were used to identify the independent risk factors of GDM (adjusted for maternal age ≥35 years, income, maternal body mass index, history of pregnancy loss and congenital anomaly) and the associated pregnancy outcomes of GDM (adjusted for maternal age, income and maternal body mass index). Adjusted relative risk (aRR) and 95% CI, used to assess the strength of associations, were reported. The cumulative incidence of GDM was 20.7%, 95% CI (17.9% to 23.9%). The mean time for the diagnosis of GDM is 25.4±1.42 weeks of gestation. After adjusting for other variables, maternal age ≥35 years: (aRR: 1.48). 95% CI (1.07 to 1.97) p=0.016), maternal obesity (aRR: 1.85, 95% CI (1.26 to 2.30) p=0.002) and a previous history of congenital anomaly (aRR: 2.83, 95% CI (1.97 to 4.07) p<0.001) were significantly associated with GDM risk. Women with GDM had a higher risk for elective CS: (RR 1.57 (95% CI: (1.04 to 2.36) p=0.032), the association was insignificant after adjustment for other variables (aRR 1.32 (95% CI: (0.86 to 2.03) p=0.199). The cumulative incidence of GDM is high among pregnant women in Ibadan. Maternal age ≥35 years, maternal obesity and a history of congenital anomaly were significant independent risk factors for GDM. These factors should be targeted for public health interventions, including lifestyle modification among pregnant women with obesity and early screening and diagnosis of GDM.

Background and aims. Due to changes in criteria of diagnosis of GDM in Russia from 2013, it is relevant to study clinical course of GDM and pregnancy outcomes depending on terms and methods of diagnosis of GDM.Material and methods. 192 pregnant women aged 29,4±5,5ys, with a body weight 68,8±14,8 kg, BMI 25,3±5,3. 1st group: 86 pregnant women with high fasting glucose level before 20th week of pregnancy, 2nd group: 43 pregnant women with hyperglycemia in OGTT after 20th week of pregnancy, 3rd group: 63 pregnant women without GDM - control group.Results. Pregnant women with GDM were older than non-GDM women (29,5±5,4ys., 30,8±5,3ys., 28,4±5,7ys, р=0,05) and had higher body weight (72,3±16,9 kg, 68,0±12,4 kg, 64,4±11,5 kg, р=0,016). There weren't difference in age, BMI between groups 1st and 2nd. The proportion of compliant women was the same in groups 1st and 2nd (38,4% and 34,9%, p=0,85). Pregnant women who needed insulin were older and had higher BMI (32,4 ± 5,3 ys. vs. 28,9 ± 5,4 ys, р=0,04; 29,7 ± 7,1vs.25,6 ± 5,7, р=0,03 respectively). The number of women treated by insulin was higher in 2nd group (46,6%vs.15,5%, p=0,03). Women, who treated by insulin, were younger and had higher BMI in 1st group compared with 2nd group (29, 0±4,7ys vs 35,0±4,3ys, р=0,03; 34,4±5,7 vs 26,1±5,9 respectively, р=0,02). There was a significant difference in delivery term and summary severe adverse outcomes (macrosomia, preterm delivery, stillbirth) between non-compliant women with GDM and 3rd group (38,6±2,7ws 1st group, 38,0±1,9ws 2nd group, 39,5±1,09ws 3rd group, р=0,008; 34,3% 1st group, 66,7% 2nd group, 19,4% 3rd group, р=0,027). The frequency of macrosomia and summary adverse pragnancy outcomes (hypoglicemia, neonatal jaundice, clavicle fracture, asphyxia) was higher in non-compliant women with GDM compared with compliant women ((29,5% vs. 12,2%, р=0,03; 70,5% vs. 46,3%, р=0,02 respectively).Conclusions: Pregnant women with GDM diagnosed on base of high fasting glucose level, need insulin less frequently. Pregnancy outcomes in women with GDM depend on compliance rather than on terms or methods of diagnosis.

BackgroundEstablished risk factors for Gestational Diabetes Mellitus (GDM) include age, ethnicity, family history of diabetes and previous GDM. Additional significant influences have recently been demonstrated in the literature. The oral glucose tolerance test (OGTT) used for GDM diagnosis has sub-optimal sensitivity and specificity, thus often results in GDM misdiagnoses. Comprehensive screening of risk factors may allow more targeted monitoring and more accurate diagnoses, preventing the devastating consequences of untreated or misdiagnosed GDM. We aimed to develop a comprehensive online questionnaire of GDM risk factors and triangulate it with the OGTT and continuous glucose monitoring (CGM) parameters to better evaluate GDM risk and diagnosis.MethodsPregnant women participating in two studies on the use of CGM for GDM were invited to complete the online questionnaire. A risk score, based on published literature, was calculated for each participant response and compared with the OGTT result. A total risk score (TRS) was then calculated as a normalised sum of all risk factors. Triangulation of OGTT, TRS and CGM score of variability (CGMSV) was analysed to expand evaluation of OGTT results.ResultsFifty one women completed the questionnaire; 29 were identified as ‘high-risk’ for GDM. High-risk ethnic background (p < 0.01), advanced age, a family diabetic history (p < 0.05) were associated with a positive OGTT result. The triangulation analysis (n = 45) revealed six (13%) probable misdiagnoses (both TRS and CGMSV discordant with OGTT), consisting of one probable false positive and five probable false negative by OGTT results.ConclusionsThis study identified pregnant women at high risk of developing GDM based on an extended evaluation of risk factors. Triangulation of TRS, OGTT and CGMSV suggested potential misdiagnoses of the OGTT. Future studies to explore the correlation between TRS, CGMSV and pregnancy outcomes as well as additional GDM pregnancy biomarkers and outcomes to efficiently evaluate OGTT results are needed.