Greater Risk Of Gestational Diabetes Mellitus Research Articles

Association of free fatty acid in first trimester with the risk of gestational diabetes mellitus: a nested case-control study

BackgroundAccumulating evidence shows that free fatty acids (FFA) are associated with gestational diabetes mellitus (GDM). However, most of the studies focus on a few specific types of FFA, such as α-linolenic acid (C18:3n3) and Arachidonic acid (C20:4n6) or a total level of FFA.ObjectiveThis study aimed to test the association between a variety of FFAs during the first trimester and the risk of GDM.MethodsThe participants came from the Zhoushan Pregnant Women Cohort (ZWPC). A 1:2 nested case-control study was conducted: fifty mothers with GDM were matched with 100 mothers without GDM by age, pre-pregnancy body mass index (BMI), month of oral glucose tolerance test (OGTT) and parity. Thirty-seven FFAs (including 17 saturated fatty acids (SFA), 8 monounsaturated fatty acids (MUFA), 10 polyunsaturated fatty acids (PUFA) and 2 trans fatty acids (TFA)) in maternal plasma during the first trimester were tested by Gas Chromatography–Mass Spectrometry (GC-MS). Conditional logistic regression models were performed to assess the associations of FFA with the risk of GDM.ResultsNine FFAs were respectively associated with an increased risk of GDM (P < 0.05), and four FFAs were respectively associated with a decreased risk of GDM (P < 0.05). SFA risk score was associated with a greater risk of GDM (OR = 1.34, 95% CI: 1.12–1.60), as well as UFA risk score (OR = 1.26, 95% CI: 1.11–1.44), MUFA risk score (OR = 1.70, 95%CI: 1.27–2.26), PUFA risk score (OR = 1.32, 95%CI: 1.09–1.59) and TFA risk score (OR = 2.51, 95%CI: 1.23–5.13). Moreover, joint effects between different types of FFA risk scores on GDM were detected. For instance, compared with those with low risk scores of SFA and UFA, women with high risk scores of SFA and UFA had the highest risk of GDM (OR = 8.53, 95%CI: 2.41–30.24), while the Odds ratio in those with a low risk score of SFA and high risk score of UFA and those with a high risk score of SFA and low risk score of UFA was 6.37 (95%CI:1.33– 30.53) and 4.25 (95%CI: 0.97–18.70), respectively.ConclusionMaternal FFAs during the first trimester were positively associated with the risk of GDM. Additionally, there were joint effects between FFAs on GDM risk.CondensationElevated FFA levels in the first trimester increased the risk of GDM.

Dietary fat intake with risk of gestational diabetes mellitus and preeclampsia: a systematic review and meta-analysis of prospective cohort studies.

Gestational diabetes mellitus (GDM) and preeclampsia (PE) are commonly observed medical complications in pregnancy. Dietary total fat and fatty acids associated with GDM and PE risk have been examined in several epidemiological studies. In some instances, systematic reviews and meta-analyses might provide more accurate dietary recommendations. This systematic review and dose-response meta-analysis was conducted to investigate the association between dietary total fat and fatty acids and the risk of GDM and PE. Research on dietary fat intake and the risk of GDM and PE was conducted through systematic searches of the PubMed, Scopus, and Web of Science databases for articles published up to August 19, 2023. An investigation of associations between dietary intake of total fat and fatty acids and the risk of GDM and PE was performed using prospective cohort study designs. Twenty-one prospective cohort studies were considered eligible. Findings indicated that higher intakes of total fat (relative risk [RR], 1.08; 95% confidence interval [CI], 1.02-1.14), animal fat (RR, 1.56; 95%CI, 1.34-1.89), vegetable fat (RR, 1.23; 95%CI, 1.05-1.45), dietary cholesterol (RR, 1.48; 95%CI, 1.10-2.00), and omega-3 fatty acid (RR, 1.11; 95%CI, 1.02-1.20) are associated with a greater risk of GDM. However, no significant association was found between dietary total fat and fatty acids and the risk of PE. Dose-response meta-analyses suggested every 10% increment in total energy intake from total fat, 5% from animal fat, 5% from vegetable fat, and 100 mg from cholesterol was related to 15%, 12%, 7%, 14%, and 20% higher GDM risk, respectively. Overall, total fat, animal fat, vegetable fat, dietary cholesterol, and omega-3 fatty acid consumption are associated with a small but statistically significant increase in GDM risk. PROSPERO (CRD42023466844).

MATERNAL DYSLIPIDEMIA AND OBESITY/GESTATIONAL DIABETES MELLITUS ARE ASSOCIATED AN UPCOMING INVESTIGATION

Background: Maternal dyslipidemia and gestational diabetes are known to be associated, however it is unknownhow obesity plays a role in this interaction. We examined the relationship between fasting lipids at the oral glucosetolerance test (OGTT) in women diagnosed with GDM and maternal obesity at the first prenatal visit.Objectives: The study aims to investigate the relationship between maternal dyslipidemia and gestational diabetesmellitus (GDM), pinpoint risk factors, elucidate procedures, and provide guidance for therapeutic treatments aimedat improving the health of expectant mothers.Study design: A prospective studyDuration and place of study: from jan 2022 to jan 2023 at Dow University Karachi, PakistanMethods: This prospective study was undertaken at Dow University Karachi, which has an annual delivery rateexceeding 150 pupils. At their first prenatal hospital visit, participants who were between the ages of 20 and 45 andhad at least one maternal risk factor for GDM were enlisted. Pregnant women with diabetes mellitus or those whohave had several pregnancies were excluded. To investigate maternal risk factors and GDM outcomes, laboratorytests were carried out, interviews were done, and medical records were examined. In the statistical analysis, logisticregression and descriptive statistics were used to find relationships between risk factors and the development of GDM.The purpose of this study at Dow University Karachi was to ascertain the impact of risk factors on the incidence ofGDM in young women.Results: The features of the research population were classified according to the presence or absence of GDM. 150women consented to participate in the research during their first prenatal visit. The study’s findings demonstrated astrong correlation between maternal traits and the prevalence of gestational diabetes mellitus (GDM). An average oflate adolescence and a younger mother age indicated a greater risk of GDM. It was noted that maternal obesity wasprevalent among individuals who had GDM and that it posed a significant risk. GDM risk was linked to specificrisk factors like a family history of diabetes mellitus, a prior diagnosis of GDM, and a high body mass index.Additionally, elevated fasting cholesterol, particularly triglycerides, and total cholesterol were particularly high in theGDM group, highlighting the importance of maternal cholesterol. These results emphasise the complexity of GDMdevelopment and the need of focused preventive measures.Conclusion: The study looked at the link between maternal dyslipidemia and gestational diabetes mellitus (GDM),emphasizing the impact obesity plays in this interaction. Although the study’s goals and methods are explained inthe abstract, the findings are regrettably not shared. However, the study has the potential to further our knowledgeof the intricate interactions among maternal Obesity, dyslipidemia, and GDM. These results may have significantramifications for identifying pregnant women who are at risk and creating focused treatments to enhance the health ofpregnant moms and their unborn children. The study’s benefits to maternal healthcare must be fully appreciated bymore Study and a comprehensive presentation of the findings.Keywords: maternal dyslipidemia, gestational diabetes mellitus (GDM), and pregnancy complications

Carbohydrate intake quality and gestational diabetes mellitus, and the modifying effect of air pollution.

Nutritional management is the cornerstone of gestational diabetes mellitus (GDM) prevention. High quality instead of low quantity of carbohydrate intake has been paying attention in controlling glycemia. Air pollution exposure can be interacted with dietary sourced nutrients, which may modify the associations with GDM. This study aims to explore the associations between overall quality of carbohydrate intake and GDM as well as the modifying effect of prenatal air pollution exposure. Carbohydrate quality index (CQI) was calculated was calculated by summing scores of the four components; Land use regression prediction models were used to assess the air pollution exposure levels. GDM definition was based on 75 g glucose tolerance test results. Associations between pre-pregnancy CQI, pre-natal air pollution as well as the modifying effect on GDM were explored based on a birth cohort in China. A total of 3,183 participants were included, of which 784 (24.63%) were diagnosed with GDM. Higher pre-pregnancy CQI was associated with a lower incidence of GDM [odds ratio (OR) = 0.75, 95% confidence interval (CI): 0.56-0.99, P for trend = 0.04], especially for higher fasting blood glucose related GDM (OR = 0.66, 95% CI: 0.47, 0.91). Higher air pollution exposure before and during pregnancy was associated with a greater risk of GDM. Higher exposure to particulate matter with an aerodynamic diameter of < 2.5 μm (P for interaction < 0.01), particulate matter with an aerodynamic diameter of < 10 μm (P for interaction < 0.01), and sulfur dioxide (P for interaction = 0.02) during pregnancy decreased the beneficial effect of high pre-pregnancy CQI on GDM. CQI related dietary interventions pre-pregnancy to prevent GDM incidence should be considered. Women who are planning to be pregnant should avoid high exposure to air pollution during pregnancy.

Is the Development of Gestational Diabetes Associated With the ABO Blood Group/Rhesus Phenotype?

AimsThere are few published data on the putative association between the ABO blood group/rhesus (Rh) factor and the risk of developing gestational diabetes mellitus (GDM). Our aim was to explore the link between each one factor and GDM development.MethodsAll women having given birth at Lille University Medical Center (Lille, France) between August 1st, 2017, and February 28th, 2018, were tested for GDM, using the method recommended in the French national guidelines. The risk of GDM was assessed for each ABO blood group, each Rh phenotype and combinations thereof, using logistic regression models.Results1194 women had at least one GDM risk factor. The percentage of GDM varied with the ABO group (p=0.013). Relative to group O women, group AB women were more likely to develop GDM (OR = 2.50, 95% CI [1.43 to 4.36], p=0.001). Compared with the Rh-positive O group, only the Rh-positive AB group had an elevated risk of developing GDM (OR = 3.02, 95% CI [1.69 to 5.39], p < 0.001).ConclusionsOur results showed that Rh-positive group AB women have a greater risk of GDM. With a view to preventing GDM, at-risk individuals could be identified by considering the ABO blood group phenotype either as a single risk factor or in combination with other risk factors.

Plasma Amino Acids in Early and Mid-Pregnancy With Subsequent Risk of Gestational Diabetes and Cardiometabolic Markers – Both Type of Amino Acids and Gestational Timing Matter

ObjectivesTo prospectively evaluate associations of plasma amino acids (AAs) in early and mid-pregnancy with gestational diabetes mellitus (GDM) risk and cardiometabolic biomarkers in a longitudinal U.S. multiracial pregnancy cohort.MethodsWe conducted a nested case-control study within the National Institute of Child Health and Human Development Fetal Growth Studies-Singleton Cohort. Individual AAs at gestational weeks (GW) of 10–14, 15–26, 23–31, and 33–39 were assessed among 107 GDM cases (mean GW for GDM ascertainment: 27.4) and 214 controls matched on age, race/ethnicity, and gestational age at sample collection. We used conditional logistic regression to estimate odds ratios (OR) and 95% confidence intervals (95% CI) for the associations of plasma AAs at 10–14 GW and 15–26 GW with subsequent risk of GDM, adjusting for major covariates. We estimated Spearman's partial correlation coefficients between AAs at 10–14 GW and fasting cardiometabolic markers at 15–26 GW.ResultsAt 10–14 GW, each SD increment in glycine levels was related to a 45% lower risk of GDM (adjusted OR, 95% CI: 0.55, 0.39–0.79), whereas each SD increase in alanine, aspartic acid, and glutamic acid was associated with a 43% (aOR, 95% CI: 1.43, 1.08–1.88), 41% (aOR, 95% CI: 1.41, 1.11–1.80), and 39% (aOR, 95% CI: 1.39, 0.98–1.98) greater risk of GDM, respectively. At 15–26 GW, similar findings to those at GW 10–14 were observed for glycine, alanine, and aspartic acid. In addition, each SD increment in glutamine-to-glutamic acid-ratio was related to a 50% lower risk of GDM (OR, 95% CI: 0.50, 0.26–0.94). By contrast, higher levels of branched-chain AA (BCAA) isoleucine and aromatic AAs tyrosine and phenylalanine were associated with a higher risk of GDM (OR, 95% CI: 1.64, 1.19–2.27 for isoleucine; 1.56, 1.16–2.09 for tyrosine; and 1.15, 0.87–1.53 for phenylalanine). Higher levels of glycine and lower levels of alanine, BCAA, and aromatic AAs were associated with a more favorable cardiometabolic biomarker profile.ConclusionsAssociations of AAs with GDM differed by both types of AAs and timing over pregnancy. These findings suggest potentially important roles of glycine in both early- and mid-pregnancy, and BCAA and aromatic AAs in mid-pregnancy in the development of GDM and maternal cardiometabolic profiles.Funding SourcesThe Eunice Kennedy Shriver NICHD, American Recovery and Reinvestment Act.

Association between maternal hepatitis B virus carrier and gestational diabetes mellitus: a retrospective cohort analysis

IntroductionGiven that many pregnant women have chronic hepatitis B virus (HBV) infection and that gestational diabetes mellitus (GDM) is linked to poor maternal and neonatal outcomes, we looked into the relationship between the hepatitis B surface antigen (HBsAg) and GDM to see if a high HBV DNA load is linked to a higher risk of GDM in chronic maternal HBsAg carriers.Materials and methodsOur study included 39,539 pregnant women who gave birth at the Third Affiliated Hospital of Guangzhou Medical University in Guangzhou, China, between January 1, 2009, and December 31, 2019. The patients were divided into two groups: HBsAg negative (36,500) and positive (3039). The viral load levels of 1250 HBsAg-positive women who had tested their HBV DNA load during pregnancy were separated into three groups. We utilized univariate and multivariable logistical regression analysis to determine the relationship between maternal chronic HBsAg carrier and GDM.ResultsBeing HBsAg positive was discovered to be an independent risk factor for GDM.Pre-pregnancy Obesity and advanced age were linked to an increased incidence of GDM. Those with a high HBV DNA load (> 106 IU/mL) had a higher risk of GDM than HBsAg-positive women with a low viral load (< 103 IU/mL). Pre-eclampsia and intrahepatic cholestasis of pregnancy (ICP) appeared to be more common in HBsAg-positive women than in uninfected women.ConclusionsBeing HBsAg positive, advanced age, and pre-pregnancy obesity were all revealed to be independent risk factors for GDM in our study. In HBsAg carrier, pregnant women, a high HBV DNA burden was linked to a greater risk of GDM. Furthermore, being an HBsAg carrier during pregnancy raised the risk of ICP and pre-eclampsia.

High early pregnancy serum 25-hydroxy vitamin D level, within a sub-optimal range, is associated with gestational diabetes mellitus: a prospective cohort study.

BACKGROUND/OBJECTIVESLow early pregnancy serum 25-hydroxy vitamin D (25[OH]D) levels can increase gestational diabetes mellitus (GDM) risk, although inconsistent findings related to that association have been reported. This study examined the association of serum vitamin D with GDM and the possible influencers on this association.SUBJECTS/METHODSThis study included 259 pregnant women within the Seremban Cohort Study (SECOST). Blood samples at < 14 weeks of gestation were drawn to determine serum 25(OH)D levels. GDM diagnosis was made at 24 to 32 weeks of gestation using a standard procedure. Association between serum vitamin D and GDM was tested using binary logistic regression.RESULTSNearly all women (90%) had mild (68.3%) or severe (32.2%) vitamin D deficiency (VDD). Non-GDM women with mild VDD had a significantly higher mean vitamin D intake than GDM women with mild VDD (t = 2.04, p < 0.05). Women with higher early pregnancy serum vitamin D levels had a greater risk of GDM. However, this significant association was only identified among those with a family history of type 2 diabetes mellitus (T2DM) and in women with a body mass index indicating overweight or obese status.CONCLUSIONSThe high prevalence of VDD in this sample of pregnant women underscores the need for effective preventive public health strategies. Further investigation of this unexpected association between serum vitamin D level and GDM risk in predominantly VDD pregnant women and the potential effects of adiposity and family history of T2DM on that association is warranted.

Starchy vegetable intake in the first trimester is associated with a higher risk of gestational diabetes mellitus: a prospective population-based study

Objective The purpose of this study was to evaluate the association between starchy vegetable consumption and subgroup consumption in the first trimester and the risk of gestational diabetes mellitus (GDM). Methods A prospective study (n = 1444) was conducted in China. Dietary information was assessed by 24-hour dietary recalls for three days and then we calculated the consumption of total starchy vegetable and its subgroups, including (1) potato and (2) other starchy vegetable (pumpkin, lotus root, yam, taro, water chestnut, pea, and cowpea). GDM was diagnosed according to the results of 75-g two-hour oral glucose tolerance test (OGTT) at 24–28 weeks of gestation. A modified log-binomial regression was used to estimate RRs and 95% CIs of GDM risk. Results Among the 1444 participants in our study, 520 were diagnosed with GDM. The adjusted RRs (95% CIs) for GDM from the lowest to the highest quartiles of total starchy vegetable consumption were 1.00 (reference), 1.29 (1.06, 1.57), 1.13 (0.93, 1.40), and 1.26 (1.02, 1.56), respectively; p for trend = .032. For potato, the RR of GDM risk was 1.32 for the highest potato intake quartile compared with the lowest quartile (95% CI 1.07–1.64, p for trend = .003). In addition, we did not observe an association between other starchy vegetable intakes and GDM risk. Conclusions A higher consumption of total starchy vegetables and potatoes in the first trimester is associated with a greater risk of GDM.

Association between sleep duration in early pregnancy and risk of gestational diabetes mellitus: a prospective cohort study

AimsAs cohort studies of the impact of sleep duration during early pregnancy on gestational diabetes mellitus (GDM) are lacking, our study aimed to explore the association between sleep duration in the first trimester and GDM in one region of mainland China. MethodsFor this prospective cohort study, sleep duration data were collected from 3692 pregnant women at the first prenatal care appointment before 14 weeks of gestation. Multivariable log-binomial regression models were used to analyze the association of sleep duration with GDM after adjusting for demographic characteristics, health status (such as family history of diabetes, history of GDM, prepregnancy body mass index, gestational weight gain) and lifestyle habits (such as physical activity, dietary intakes). ResultsOur cohort included 166 (4.5%) short sleepers and 505 (14%) long sleepers. Shorter sleep duration was more likely to be observed in women aged ≥35 years who were multiparous, and had previous pregnancy, insufficient gestational weight gain, engaged in more vigorous physical activity, drank alcohol, were vegan and/or never took folic-acid supplements. Compared with normal sleepers (29%), the prevalence of GDM was significantly higher in short sleepers (38%; P = 0.01), but not in long sleepers (31%; P = 0.224). In the multivariable model, women with short sleep durations during early pregnancy had a 32% greater risk of GDM [adjusted risk ratio (aRR): 1.32, 95% CI: 1.06–1.63], whereas long sleepers did not (aRR: 1.09, 95% CI: 0.94–1.26). ConclusionShort sleep duration during early pregnancy is associated with an increased risk of GDM. This suggests that more attention should be paid to controlling the development of GDM in pregnant women with insufficient sleep.

Endometriosis and Risk of Adverse Pregnancy Outcomes.

To investigate the relationship between endometriosis and adverse pregnancy outcomes. Women between ages 25 and 42 years in 1989 (n=116,429) reported detailed information on pregnancies and reproductive health at baseline and every 2 years thereafter in the Nurses' Health Study II, a cohort study. In 2009, they completed a detailed, pregnancy-focused questionnaire. A total of 196,722 pregnancies were reported. Adverse pregnancy outcomes included spontaneous abortion, ectopic pregnancy, stillbirth, gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (preeclampsia or gestational hypertension), preterm birth, and low birth weight. We estimated the relative risks (RRs) and 95% CIs of adverse pregnancy outcomes comparing pregnancies in women with and without a history of laparoscopically confirmed endometriosis using multivariable log-binomial regression, with generalized estimating equations to account for multiple pregnancies per woman. Endometriosis was associated with a greater risk of pregnancy loss (spontaneous abortion: RR 1.40, 95% CI 1.31-1.49; ectopic pregnancy: RR 1.46, 95% CI 1.19-1.80). Endometriosis was also associated with a greater risk of GDM (RR 1.35, 95% CI 1.11-1.63) and hypertensive disorders of pregnancy (RR 1.30, 95% CI 1.16-1.45). We observed an association between laparoscopically confirmed endometriosis and several adverse pregnancy outcomes. Future research should focus on the potential biological pathways underlying these relationships to inform screening or preventive interventions.

Pregnancy dietary cholesterol intake, major dietary cholesterol sources, and the risk of gestational diabetes mellitus: A prospective cohort study

The Scientific Report of 2015 Dietary Guidelines Advisory Committee recommended the elimination of dietary cholesterol limits. However, cholesterol intake increases during pregnancy and studies regarding the association between dietary cholesterol and gestational diabetes mellitus (GDM) are limited. We evaluate the association of total dietary cholesterol and different sources of cholesterol intake during pregnancy, with GDM risk and blood glucose levels in a Chinese prospective cohort study. A total of 2124 pregnant women from the Tongji Maternal and Child Health Cohort was included. A validated semi-quantitative food frequency questionnaire was used to assess dietary cholesterol intake prior to GDM diagnosis. GDM was diagnosed by the 75-g 2-h oral glucose tolerance test. Cubic-restricted spline function and logistic regression analyses were used to evaluate the association between dietary cholesterol intake during pregnancy and GDM. Generalized linear models were conducted to examine the associations of cholesterol intake with fasting blood glucose (FBG), 1-h post-load blood glucose (PBG) and 2-h PBG. The average dietary cholesterol intake was 379.1mg/d, and cholesterol from eggs explained 64.2% of the variability. Total dietary cholesterol intake and cholesterol from eggs rather than other foods, were linearly associated with GDM risk, with adjusted OR for GDM of 2.10 (95%CI: 1.24, 3.58) for total cholesterol intake and 1.83 (95%CI: 1.08, 3.07) for cholesterol from eggs comparing the highest versus lowest quintile. A 100-mg/d increase in total cholesterol and cholesterol from eggs intake were associated with an increased GDM risk by 18% and 16%, respectively. Moreover, higher maternal dietary total cholesterol could increase FBG and 1-h PBG, while cholesterol from eggs increased FBG only. Higher dietary cholesterol from eggs intake during pregnancy was associated with greater risk of GDM.

Plasma concentrations of lipids during pregnancy and the risk of gestational diabetes mellitus: A longitudinal study

Abnormal lipid profiles have been associated with gestational diabetes mellitus (GDM), but studies with longitudinal measures of lipids throughout pregnancy are sparse. The aim of the present study was to characterize longitudinal changes in lipid profiles throughout pregnancy and prospectively examine the associations of plasma lipid concentrations with risk of GDM. This study was a nested case-control study including 107 GDM cases and 214 matched non-GDM controls from participants in the National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies - Singleton cohort. Blood samples were collected longitudinally at Gestational Weeks (GW) 10-14, 15-26 (fasting sample), 23-31, and 33-39. Plasma concentrations of triglycerides, total cholesterol, and high-density lipoprotein cholesterol (HDL-C) were measured by enzymatic assays. Low-density lipoprotein cholesterol (LDL-C) was calculated using Friedewald's formula. Plasma triglycerides, total cholesterol, and LDL-C increased as pregnancy progressed. At GW 10-14, the adjusted odds ratios (aORs) of GDM comparing the highest versus lowest quartile were 3.15 (95% confidence interval [CI] 1.38-7.15; P trend = 0.002) for triglycerides and 0.44 (95% CI 0.18-1.09; P trend = 0.045) for HDL-C. At GW 15-26, the aORs were 6.57 (95% CI 2.25-19.17; P trend = 0.001) for triglycerides and 0.23 (95% CI 0.08-0.63; P trend = 0.005) for HDL-C. No significant associations were observed for total cholesterol and LDL-C concentrations with risk of GDM. Higher plasma triglyceride and lower HDL-C concentrations in early and mid-pregnancy were significantly associated with a greater risk of GDM. Total cholesterol and LDL-C concentrations during pregnancy were not significantly associated with GDM risk.

Pre-pregnancy weight change and incidence of gestational diabetes mellitus: A finding from a prospective cohort study

In a population-based cohort study we examined the associations between early adult pre-pregnancy weight change and the risk of gestational diabetes mellitus (GDM). The study included 3111 women from the 1973-78 cohort of the Australian Longitudinal Study on Women's Health. These women have been surveyed regularly since 1996. Women without diabetes and GDM were followed-up between 2003 and 2012. Generalized estimating equations were used to assess the effect of baseline (1996, mean age 20years) and pre-pregnancy body mass index (BMI) and the pre-pregnancy weight changes on the incidence of GDM. The full models were adjusted for sociodemographic and lifestyle factors. From 2003 to 2012, 229GDM cases (4.4%) were reported in 5242 pregnancies. Relative to normal BMI women, obese women at baseline (RR: 1.8, 95% CI: 1.1, 2.8) and prior to pregnancy (RR: 2.7, 95% CI: 2.0, 3.6) were at greater risk of GDM. Weight gains prior to each study pregnancy were strongly associated with increased GDM risk with an adjusted RR ranging from 2.0 to 2.9. Within under/normal range of BMI, women with a moderate/high (>2.5%/year) weight gain had 2.7 (95% CI: 1.3, 5.5) times the risk of GDM compared with women with stable weight. Early adult weight gain, even within normal BMI range, is an important risk factor for the development of GDM. Weight gain prevention from early adulthood to prior to pregnancy appears to be the main strategy to prevent the incidence of GDM.

Pre-pregnancy potato consumption and risk of gestational diabetes mellitus: prospective cohort study

Study question What is the association between potato consumption before pregnancy and the risk of gestational diabetes mellitus (GDM)?Methods This prospective cohort study included 15 632 women from the Nurses’...

Abstract P107: Are Sleep Disturbances Associated with the Development of Gestational Diabetes? A Systematic Review and Meta-analysis.

Introduction and objectives: Physiological and hormonal changes occurring in pregnancy increase the risk of sleep disordered breathing (SDB), which, along with short sleep (SS) duration, may be associated with an increased risk of gestational diabetes mellitus (GDM). Exposure to GDM in the mother increases her lifetime risk of type-2 diabetes (T2D) as well as the risk of obesity, metabolic syndrome and, in later life, T2D of her children. The aim of this study was to systematically review the collective published evidence of associations between snoring/sleep-disordered breathing or sleep duration and increased risk of GDM. Hypothesis: We assessed the hypotheses that sleep disturbances, and/or short sleep during pregnancy may be associated with an increased risk of GDM. Materials and Methods: We performed systematic searches using MEDLINE, EMBASE, the Cochrane library and PsycINFO to assess the effect of snoring/sleep disordered breathing (SDB) or short sleep (SS) on the development of gestational diabetes (GDM) and impaired glucose tolerance in pregnancy. Prospective studies with measures of sleep disturbances at baseline and outcome measures of GDM or levels of glucose 1hr post GCT were included in a meta-analysis. We extracted odds ratios (OR) or relative risks (RR) and 95% confidence intervals (CI) and pooled them using a random effect model. Results: Overall, 7 studies met the inclusion criteria. They included 4,292 participants with 311 cases of GDM. In the pooled analysis, snoring/SDB and SS were both associated with a greater risk of GDM (RR: 2·27; 95% CI 1·65 to 3·12; P &lt; 0· 00001) and (3·19 [1·56 to 6·54]; P &lt; 0·002), respectively. There was no evidence of heterogeneity but there was evidence of publication bias and not all studies adjusted for obesity. Sensitivity analyses did not influence the pooled risk estimates. Conclusions: In conclusion, sleep disturbances may represent a risk factor for the development of GDM. Further studies are required to address the issues of publication bias and potential confounding, and to extend these observations to high-risk groups like women of ethnic minority groups whose risk of GDM is the greatest. Prevention, detection and treatment strategies need to be explored.

Prepregnancy Dietary Protein Intake, Major Dietary Protein Sources, and the Risk of Gestational Diabetes Mellitus

OBJECTIVEDietary protein is an important modulator of glucose metabolism. However, studies regarding the association between dietary protein intake and gestational diabetes mellitus (GDM) risk are sparse. This study was to examine the association.RESEARCH DESIGN AND METHODSOur study included 21,457 singleton pregnancies reported among 15,294 participants of the Nurses' Health Study II cohort between 1991 and 2001. Included pregnancies were free of chronic diseases before pregnancy or previous GDM. Generalized estimating equations were used to estimate the relative risks (RRs) and 95% CIs.RESULTSAfter adjustment for age, parity, nondietary and dietary factors, and BMI, multivariable RRs (95% CIs) comparing the highest with lowest quintiles were 1.49 (1.03–2.17) for animal protein intake and 0.69 (0.50–0.97) for vegetable protein intake. The substitution of 5% energy from vegetable protein for animal protein was associated with a 51% lower risk of GDM (RR [95% CI], 0.49 [0.29–0.84]). For major dietary protein sources, multivariable RRs (95% CIs) comparing the highest with the lowest quintiles were 2.05 (1.55–2.73) for total red meat and 0.73 (0.56–0.95) for nuts, respectively. The substitution of red meat with poultry, fish, nuts, or legumes showed a significantly lower risk of GDM.CONCLUSIONSHigher intake of animal protein, in particular red meat, was significantly associated with a greater risk of GDM. By contrast, higher intake of vegetable protein, specifically nuts, was associated with a significantly lower risk. Substitution of vegetable protein for animal protein, as well as substitution of some healthy protein sources for red meat, was associated with a lower risk of GDM.

International migration and gestational diabetes mellitus: a systematic review of the literature and meta‐analysis

Influxes of migrant women of childbearing age to receiving countries have made their perinatal health status a key priority for many governments. The international research collaboration Reproductive Outcomes And Migration (ROAM) reviewed published studies to assess whether migrants in countries of resettlement have a greater risk of gestational diabetes mellitus (GDM) than women in receiving countries. A systematic review of the literature from Medline, Embase, PsychInfo and CINAHL from 1990 to 2009 included studies of migrant women and GDM. Studies were excluded if there was no cross-border movement or comparison group or if the receiving country was not the country of resettlement. Studies were assessed for quality, analysed descriptively and meta-analysed. Twenty-four reports (representing >120,000 migrants) met our inclusion criteria. Migrants were described primarily by geographic origin; other relevant aspects (e.g. time in country, language fluency) were rarely studied. Migrants' results for GDM were worse than those for receiving-country women in 79% of all studies. Meta-analyses showed that, compared with receiving-country women, Caribbean, African, European and Northern European women were at greater risk of GDM, while North Africans and North Americans had risks similar to receiving-country women. Although results of the 31 comparisons of Asians, East Africans or non-Australian Oceanians were too heterogeneous to provide a single GDM risk estimate for migrant women, only one comparison was below the receiving-country comparison group, all others presented a higher risk estimate. The majority of women migrants to resettlement countries are at greater risk for GDM than women resident in receiving countries. Research using clear, specific migrant definitions, adjusting for relevant risk factors and including other aspects of migration experiences is needed to confirm and understand these findings.