SUN-633 Increased Risk of Gestational Diabetes Mellitus in Egyptian Females Undergoing In Vitro Fertilization in Alexandria

Abstract

BACKGROUND: Gestational diabetes mellitus (GDM) is one of the most frequent maternal complications during pregnancy. It has been estimated that most of the cases of hyperglycemia during pregnancy are attributed to GDM (75–90%). Pregnancy complicated with GDM is associated with adverse acute and long term consequences for both mother and infant. Risk factors for GDM include; a previous history of GDM, a family history of type 2 DM, advanced maternal age, overweight, and polycystic ovary syndrome (PCOS). This was an observational prospective study, using data of pregnant women conceived following in vitro fertilization (IVF) and spontaneously, aimed to determine the risk of GDM among Egyptian females following IVF compared to spontaneous pregnancy. The present study included two age and BMI- matched groups. Group I (GpI): 55 pregnant females conceived by IVF, and Group II (GpII): 55 pregnant females conceived spontaneously. We excluded females with a history of pre-pregnancy diabetes, glucose intolerance, corticosteroid therapy, twin pregnancy, and age above 39 years. In addition to detailed history taking, clinical examination and routine laboratory investigations, one- step oral glucose tolerance test (OGTT) was performed at gestational week 20 and 28 in all subjects. Fetal biometric measurements were performed in the third trimester using ultrasonography assessment. Results: On using the one-step strategy (75 gm OGTT test) to screen for GDM at 28 weeks of gestation; GDM was statistically significantly higher in Gp I (who had undergone IVF) compared to Gp II (spontaneous pregnancy) (20% and 5.5% respectively), p= 0.022. Moreover, it was also noticed that GDM occurred earlier on screening at 20 weeks of gestation in Gp I (16.4%) compared to (3.6%) in Gp II, p= 0.026. Among subjects who had undergone IVF (Gp I), 18.2% had a history of PCOS. There was no statistically significant difference in the incidence of GDM among subjects with PCOS compared to those without a history of PCOS at gestational week 20 and at week 28 in Gp I (p=0.661, and p=0.099 respectively). Data of fetal biometry done at the third trimester showed no significant statistical difference in head circumference, biparietal diameter, abdominal circumference or femur length between both groups. However, fetal body weight was significantly higher in the IVF group (Gp I) compared to (Gp II), p=0.003.Conclusion: These findings show that IVF may increase the risk for GDM, moreover, GDM occurs earlier, recommending selective early screening for GDM in this population.