Risk Factors for Gestational Diabetes: from an Epidemiological Standpoint

Abstract

Gestational diabetes mellitus (GDM), a common pregnancy complication, continues to be a significant public health and clinical problem, as it carries significant short-term and long-term adverse health outcomes for both mothers and offspring. Moreover, accumulating evidence from in vivo and animal studies demonstrate that maternal hyperglycemia impairs embryogenesis as early as the pre-implantation stages of development. Collectively, these data highlight the significance of understanding risk factors for GDM and preventing GDM among high-risk populations. This chapter summarizes well-characterized risk factors for GDM and reviews major methodological concerns on available epidemiological studies of GDM risk factors. Moreover, this chapter provides a comprehensive review of emerging novel modifiable risk factors that may contribute to the early prevention of GDM. The majority of women with GDM have β-cell dysfunction against a background of chronic insulin resistance to which the insulin resistance of pregnancy is partially additive. Factors that contribute to insulin resistance before pregnancy may also have a deleterious effect during pregnancy, and may constitute risk factors for GDM. Therefore, this chapter reviews risk factors of GDM important in the time window both before and during pregnancy.