Abstract
ObjectiveTo assess the incidence and risk factors for hyperglycemia in pregnancy in a cohort of Brazilian nulliparous pregnant women.Materials and methodsThis is a secondary analysis of a multicenter cohort study that enrolled 1,008 nulliparous pregnant women at 19–21 weeks. Exclusion criteria included chronic exposure to corticosteroids and previous diabetes. Bivariate and multivariate analyses by Poisson regression were used to identify associated factors.ResultsThe incidence of hyperglycemia in pregnancy was 14.9% (150/1,008), and 94.7% of these cases were gestational diabetes mellitus (142/150). Significant associated factors included a family history of diabetes mellitus, maternal overweight or obesity at enrollment, and previous maternal conditions (polycystic ovarian syndrome, thyroid dysfunctions and hypertensive disorders). A BMI ≥ 26.3Kg/m2 (RRadj 1.87 [1.66–2.10]) and a family history of diabetes mellitus (RRadj 1.71 [1.37–2.15]) at enrollment were independent risk factors for HIP.ConclusionsA family history of diabetes mellitus and overweight or obesity (until 19–21 weeks of gestation) may be used as selective markers for HIP in Brazilian nulliparous women. Given the scarcity of results in nulliparous women, our findings may contribute to determine the optimal diagnostic approach in populations of similar socioeconomic characteristics.
Highlights
The International Association of Diabetes and Pregnancy Study Group (IADPSG) and the International Federation of Gynecology and Obstetrics (FIGO) divided hyperglycemia in pregnancy (HIP into two distinct conditions: Diabetes in pregnancy (DIP) and Gestational Diabetes Mellitus (GDM)
diabetes in pregnancy (DIP) is defined as diabetes diagnosed before pregnancy o hyperglycemia with first recognition during pregnancy according to WHO diagnostic criteria for non-pregnant women that may occur at any time during pregnancy including the first trimester
gestational diabetes mellitus (GDM) is defined as pregnancy related hyperglycemia OR hyperglycemia with first recognition during pregnancy that may occur at any time during pregnancy, but most likely occurs after 24 weeks of gestation [1,2,3,4]
Summary
This is a secondary analysis of a multicenter cohort study that enrolled 1,008 nulliparous pregnant women at 19–21 weeks. Exclusion criteria included chronic exposure to corticosteroids and previous diabetes. Bivariate and multivariate analyses by Poisson regression were used to identify associated factors
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