Impact Of Gestational Diabetes Mellitus Research Articles

Gestational diabetes mellitus and development of intergenerational non-alcoholic fatty liver disease (NAFLD) after delivery: a systematic review and meta-analysis

It is known that gestational diabetes mellitus (GDM)-complicated pregnancies could affect maternal cardiometabolic health after delivery, resulting in hepatic dysfunction and a heightened risk of developing non-alcoholic fatty liver disease (NAFLD). Hence, this study aims to summarise existing literature on the impact of GDM on NAFLD in mothers and investigate the intergenerational impact on NAFLD in offspring. Using 4 databases (PubMed, Embase, Web of Science and Scopus) between January 1980 and December 2023, randomized controlled trials and observational studies that assessed the effect of maternal GDM on intergenerational liver outcomes were extracted and analysed using random-effects meta-analysis to investigate the effect of GDM on NAFLD in mothers and offspring. Pooled odds ratio (OR) was calculated using hazards ratio (HR), relative risk (RR), or OR reported from each study, with corresponding 95% confidence intervals (CI), and statistical heterogeneity was assessed with the Cochran Q-test and I2 statistic, with two-sided p values. The study protocol was pre-registered on PROSPERO (CRD42023392428). Twenty studies pertaining to mothers and offspring met the inclusion criteria and 12 papers were included further for meta-analysis on intergenerational NAFLD development. Compared with mothers without a history of GDM, mothers with a history of GDM had a 50% increased risk of developing NAFLD (OR 1.50; 95% CI: 1.21-1.87, over a follow-up period of 16 months-25 years. Similarly, compared with offspring born to non-GDM-complicated pregnancies, offspring born to GDM-complicated pregnancies displayed an approximately two-fold elevated risk of NAFLD development (2.14; 1.57-2.92), over a follow-up period of 1-17.8 years. This systematic review and meta-analysis suggests that both mothers and offspring from GDM-complicated pregnancies exhibit a greater risk to develop NAFLD. These findings underline the importance of early monitoring of liver function and prompt intervention of NAFLD in both generations from GDM-complicated pregnancies. No funding was available for this research.

Gestational diabetes mellitus is associated with greater incidence of dementia during long-term post-partum follow-up.

The impact of gestational diabetes mellitus (GDM) on incident dementia is unknown. Our aim was to evaluate the relationship between GDM and all-cause dementia and the mediating effects of chronic diseases on this relationship. This prospective cohort study included women from the UK Biobank who were grouped based on GDM history. Multivariate Cox proportional hazard models were used to explore the associations between GDM and dementia. We further analysed the mediating effects of chronic diseases on this relationship and the interactions of covariates. A total of 1292 women with and 204,171 women without a history of GDM were included. During a median follow-up period of 45 years after first birth, 2921 women were diagnosed with dementia. Women with a GDM history had a 67% increased risk of incident dementia (hazard ratio 1.67, 95% confidence interval: 1.03-2.69) compared with those without a GDM history. According to mediation analyses, type 2 diabetes, coronary heart disease, chronic kidney disease and comorbidities (diagnosed with any two of the three diseases) explained 34.5%, 8.4%, 5.2% and 18.8% of the mediating effect on the relationship. Subgroup analyses revealed that physical activity modified the association between GDM history and dementia (p for interaction=0.030). Among physically inactive women, GDM was significantly associated with incident dementia; however, this association was not observed among physically active women. A history of GDM was associated with a greater risk of incident dementia. Type 2 diabetes partially mediated this relationship. Strategies for dementia prevention might be considered for women with a history of GDM.

Quantifying fetal heart health in gestational diabetes: a new approach with fetal heart quantification technology

ObjectiveThis study aimed to assess the impact of gestational diabetes mellitus (GDM) on fetal heart structure and function using a technique called fetal heart quantification (Fetal HQ), with a focus on mitochondrial dynamics, which employs advanced imaging technology for comprehensive analysis.MethodsA total of 180 fetuses with normal heart structures, aged 24–40 weeks of gestation, were examined. A 2–3 s cine loop in the standard four-chamber oblique view was captured and analyzed using the speckle-tracking technique with Fetal HQ. Various echocardiographic parameters were evaluated, including four-chamber view (4CV), global spherical index (GSI), global longitudinal strain (GLS), 24-segment spherical index (SI), ventricular fractional area change (FAC), cardiac output (CO), and stroke volume (SV). These parameters were compared between the GDM group and the control group during two gestational periods: 24+0 to 28+0 weeks and 28+1 to 40+1 weeks. Statistical analysis was performed using independent samples t-tests and Mann-Whitney U tests to identify significant differences.ResultsTwenty fetuses from mothers with GDM and 40 from the control group were recruited at 24+0 to 28+0 weeks. At 28+1 to 40+1 weeks, 40 fetuses from mothers with GDM and 80 from the control group were recruited. The fetal left ventricular global longitudinal function was similar between the GDM and control groups. However, compared to the controls, right ventricular function in the GDM group was lower only at 28+1 to 40+1 weeks. In the GDM group, the global spherical index (GSI) was lower than in the control group at 28+1 to 40+1 weeks (1.175 vs. 1.22; p = 0.001). There were significant decreases in ventricular FAC (38.74% vs. 42.83%; p < 0.0001) and 4CV GLS for the right ventricle (−22.27% vs. −26.31%; p = 0.005) at 28+1 to 40+1 weeks.ConclusionOur findings suggest that GDM is associated with decreased right ventricular function in the fetal heart, particularly during the later stages of pregnancy (28+1 to 40+1 weeks), compared to fetuses from healthy pregnancies. The Fetal HQ technique represents a valuable tool for evaluating the structure and function of fetal hearts affected by GDM during the advanced stages of pregnancy.

Assessment of Women's Awareness of the Effects of Gestational Diabetes Mellitus on the Mother and Fetus in Saudi Arabia: A Cross-Sectional Study.

Introduction Gestational diabetes mellitus (GDM) is a form of glucose intolerance that arises during pregnancy, affecting a significant portion of women. It has immediate and long-term effects on both the mother and fetus, including complications like preeclampsia, premature delivery, and an increased risk of cesarean sections. A cross-sectional study among Saudi Arabia's general population, which included 979 women aged between 18 and 60, found varying levels of awareness of GDM, emphasizing the need for more research on awareness levels regarding GDM in Saudi Arabia and more educational campaigns to improve awareness. Objectives The study evaluates the knowledge of pregnant women about GDM and its implications for the mother and fetus. It investigates the relationship between knowledge levels and demographic factors like age, education, and socioeconomic status, aiming to identify knowledge gaps regarding this health issue and develop targeted educational initiatives. Methodology This was a cross-sectional study that included 979 women and was conducted using a Google Forms (Google Inc., Mountainview, CA) questionnaire. The questionnaire covered demographics and explored the knowledge level of women about the impact of GDM on the mother and fetus. Statistical analysis was implemented by IBM SPSS software version 27.0 (IBM Corp., Armonk, NY), with a 5% significance level. Ethical approval was sought, emphasizing anonymous data collection. We did not collect any identifying or private information from participants, and all responses were kept confidential. Results A study of 979 women revealed that their knowledge of GDM was significantly influenced by their age, gestational age, and the number of prior deliveries (p-value < 0.05). The total mean knowledge score for women's correct responses stood at 7.62 (±4.49). The study found that a majority of women, exceeding 60%, accurately answered certain questions about GDM, such as its association with heightened risks, neonatal intensive care unit (NICU) admissions, cesarean section likelihood, high birth weight, and preeclampsia. However, less than 30% could answer yes to questions that indicated that GDM could increase the risk of shoulder dystocia, hypoglycemia at birth, premature rupture of membranes, postpartum hemorrhage, and vacuum delivery. Conclusion There is a need for targeted educational initiatives, particularly focusing on knowledge gaps that women are lacking regarding GDM. Age and prior deliveries were identified as significant determinants of knowledge levels.

Gestational diabetes and the risk of type 2 diabetes in postnatal period

Gestational Diabetes Mellitus (GDM) is the most common pregnancy complication, affecting 14% of global pregnan- cies. This literature review emphasizes the importance of developing universal screening and diagnostic criteria in pregnancy. Screening criteria, as outlined by organizations like NICE and WHO, vary, reflecting the ongoing debate about the most effective diagnostic methods. GDM is linked with significant risk factors, and timely diagnosis enables intervention strategies to prevent adverse obstetric outcomes. This review underscores the lasting impact of GDM on maternal health, increasing the risk of Type 2 Diabetes (T2D), particularly in the first five years post-delivery. Despite this risk, there is a notable gap in preventive care and postnatal screening. Barriers include the absence of a universal protocol, unclear responsibilities among healthcare professionals, and challenges faced by women in the postnatal period. The low uptake of postnatal testing increases potential risks of entering a future pregnancy with undiagnosed type 2 diabetes. This review highlights the urgent need for effective postpartum interventions, emphasizing education for women to prevent type 2 diabetes and ensuring safe subsequent pregnancies. There is a need for comprehensive, universal postnatal care strategies to address the increasing prevalence of type 2 diabetes globally.

Gestational Diabetes Mellitus Subtypes Classified by Oral Glucose Tolerance Test and Maternal and Perinatal Outcomes: Results of a Mexican Multicenter Prospective Cohort Study "Cuido Mi Embarazo".

This study explores the impact of gestational diabetes mellitus (GDM) subtypes classified by oral glucose tolerance test (OGTT) values on maternal and perinatal outcomes. This multicenter prospective cohort study (May 2019-December 2022) included participants from the Mexican multicenter cohort study Cuido mi Embarazo (CME). Women were classified into four groups per 75-g 2-h OGTT: 1) normal glucose tolerance (normal OGTT), 2) GDM-Sensitivity (isolated abnormal fasting or abnormal fasting in combination with 1-h or 2-h abnormal results), 3) GDM-Secretion (isolated abnormal values at 1-h or 2-h or their combination), and 4) GDM-Mixed (three abnormal values). Cesarean delivery, neonates large for gestational age (LGA), and pre-term birth rates were among the outcomes compared. Between-group comparisons were analyzed using either the t-test, chi-square test, or Fisher's exact test. Of 2,056 Mexican pregnant women in the CME cohort, 294 (14.3%) had GDM; 53.7%, 34.4%, and 11.9% were classified as GDM-Sensitivity, GDM-Secretion, and GDM-Mixed subtypes, respectively. Women with GDM were older (p = 0.0001) and more often multiparous (p = 0.119) vs without GDM. Cesarean delivery (63.3%; p = 0.02) and neonate LGA (10.7%; p = 0.078) were higher in the GDM-Mixed group than the overall GDM group (55.6% and 8.4%, respectively). Pre-term birth was more common in the GDM-Sensitivity group than in the overall GDM group (10.2% vs 8.5%, respectively; p=0.022). At 6 months postpartum, prediabetes was more frequent in the GDM-Sensitivity group than in the overall GDM group (31.6% vs 25.5%). Type 2 diabetes was more common in the GDM-Mixed group than in the overall GDM group (10.0% vs 3.3%). GDM subtypes effectively stratified maternal and perinatal risks. GDM-Mixed subtype increased the risk of cesarean delivery, LGA, and type 2 diabetes postpartum. GDM subtypes may help personalize clinical interventions and optimize maternal and perinatal outcomes.

Getting a "SMART START" to gestational diabetes mellitus education: a mixed-methods pilot evaluation of a knowledge translation tool in primary care.

South Asian people living in Canada face higher rates of gestational diabetes mellitus (GDM) compared to national trends. The objective of this study was to design and pilot test a knowledge translation (KT) tool to support GDM prevention counselling in primary care. This study is a mixed-methods pilot evaluation of the "SMART START" KT tool involving 2 family physicians in separate practices and 20 pregnant South Asians in Ontario, Canada. We conducted the quantitative and qualitative components in parallel, developing a joint display to illustrate the converging and diverging elements. Between January and July 2020, 20 South Asian pregnant people were enrolled in this study. A high level of acceptability was received from patients and practitioners for timing, content, format, language, and interest in the interventions delivered. Quantitative findings revealed gaps in patient knowledge and behaviour in the following areas: GDM risk factors, the impact of GDM on the unborn baby, weight gain recommendations, diet, physical activity practices, and tracking of weight gain. From the qualitative component, we found that physicians valued and were keen to engage in GDM prevention counselling. Patients also expressed personal perceptions of healthy active living during pregnancy, experiences, and preferences with gathering and searching for information, and key preventative behaviours. Building on this knowledge can contribute to the design and implementation of other research opportunities or test new hypotheses as they relate to GDM prevention among South Asian communities.

Exploring Plasma-Level Gut Microbiota Mediators and Pro-Inflammatory Markers in Pregnant Women with Short Cervix and Gestational Diabetes Mellitus.

The composition of the gut microbiota (GM) undergoes significant changes during pregnancy, influenced by metabolic status, energy homeostasis, fat storage, and hormonal and immunological modifications. Moreover, dysbiosis during pregnancy has been associated with preterm birth, which is influenced by factors such as cervical shortening, infection, inflammation, and oxidative stress. However, dysbiosis also affects the levels of lipopolysaccharide-binding protein (LBP), short-chain fatty acids (SCFAs), and free fatty acids (FFA) in other tissues and the bloodstream. In this study, we investigated the plasmatic levels of some pro-inflammatory cytokines, such as matrix metalloproteinases-8 (MMP-8), interleukin-8 (IL-8), heat shock protein 70 (Hsp70), and microbial markers in pregnant women with a short cervix (≤25 mm) compared to those with normal cervical length (>25 mm). We examined the differences in the concentration of these markers between the two groups, also assessing the impact of gestational diabetes mellitus. Understanding the relationship between GM dysbiosis, inflammatory mediators, and cervical changes during pregnancy may contribute to the identification of potential biomarkers and therapeutic targets for the prevention and management of adverse pregnancy outcomes, including preterm birth.

The impact of gestational diabetes mellitus on perceived mother-infant bonding: a qualitative study

ABSTRACT Background The prevalence of gestational diabetes mellitus (GDM) is rapidly increasing. It is associated with adverse physical and mental health outcomes for women and their babies. Mother-infant bonding is important for maternal health and infant development, but the effect of GDM on mother-infant bonding has not been examined. Objective To explore and describe the impact of GDM on perceived mother infant-bonding in the antenatal and postnatal period. Methods Qualitative, individual, semi-structured interviews were conducted with 33 women from diverse backgrounds with current or previous GDM. Data were analysed using reflexive inductive thematic analysis. Results Three main themes were generated from the analysis: 1) Concern for baby's health and its impact on bonding; 2) GDM management, the pregnancy experience, and bonding; 3) Continuity and discontinuity of the impact on bonding between the antenatal and postnatal periods. Conclusion It was found that GDM can have both positive and negative impacts on perceived mother-infant bonding, which appear to change over the course of the perinatal period. Further observational research is needed to assist in understanding the impact of GDM on mother-infant bonding and the potential mediating effect of mental disorders, including depression.

"It feels like medically promoted disordered eating": The psychosocial impact of gestational diabetes mellitus in the perinatal period.

The global prevalence of gestational diabetes mellitus (GDM) is increasing, and it can significantly impact women's psychosocial outcomes in the perinatal period. The aim of this study was to explore the psychosocial impacts including experiences of support for women with GDM in the antenatal and postnatal period. Semi-structured individual interviews were conducted with women (n = 33) living in the UK, who were either pregnant and recently diagnosed with GDM or had a previous GDM diagnosis within the past three years. Interviews were recorded, transcribed, and analysed using reflexive thematic analysis. Analysis revealed six themes: 1. Diagnostic related frustration; 2. Impact on mental health; 3. The medicalisation of eating; 4. Losing agency to gain control; 5. Sourcing networks of support; 6. Current pregnancy; and future reproductive health. Each theme provides a unique insight into the experiences and psychological strain associated with GDM. From confusion and frustration at diagnosis, to the profound knock-on impact a diagnosis, associated lifestyle changes and medical appointments had on women's mental health, and the perceived medicalisation of their eating behaviours and patterns. Given the increasing prevalence of GDM and its wide-ranging psychosocial impacts, this study emphasises the need for healthcare professionals to consider the potential implications of GDM on women's psychosocial outcome, and to consider alternative support options outside of the medical system, such as peer support.

The Impact of Gestational Diabetes Mellitus on the Composition of Breast Milk: A Systematic Review

Gestational diabetes mellitus (GDM) is a pregnancy complication that affects the health of both the infant and maternal. Breast milk is the optimal food for the infant, including nutrients that support the infant's physical metabolism and biologically active components that help the infant's functional development. This article is a systematic review of published literature on the effects of GDM on the component of mother’s milk. This review analyzed a total of 28 articles reporting a total of 83 breast milk constituents associated with GDM, 37 of which were biologically active. In conclusion, GDM may change human milk composition but the paucity of studies and the considerable heterogeneity of their designs and methods make it difficult to draw reliable and relevant conclusions.

Prothrombin time and activated partial thromboplastin time in women with gestational diabetes mellitus

Impact of gestational diabetes mellitus (GDM) on the coagulation system still remains unclear and there is limited data available regarding haemostatic changes in GDM in Bangladesh. This study was aimed at determining plasmaprothrombin time (PT), activated partial thromboplastin time (APTT) in women with GDM. This cross sectional study encompassed 44 GDM (age: 28.5±3.8 years, BMI: 27.2±4.0kg/m2; mean±SD) and equal number of pregnant women with normal glucose tolerance (NGT) diagnosed on the basis of WHO criterion 2013 at or after 24 weeks of gestation to see PT and APTT. Plasma glucose was measured by glucose oxidase method, PT and APTT by automated coagulation analyzer. There was no statistically significant difference between the GDM and NGT groups for PT (12.3±0.5 vs. 12.2±0.4 sec, mean±SD; P=0.40) or APTT (30.53±1.01 vs. 30.9±4.5 sec, mean±SD; P=0.56). In conclusion, PT and APTT do not differ between women with or without GDM. BSMMU J 2022; 15(3): 146-150

Ethnic differences in the impact of gestational diabetes on macrosomia.

Previous studies reported an ethnic disparity in gestational diabetes mellitus-associated birth outcomes, with some suggesting that macrosomia increases to a lesser extent in groups at high risk, the opposite of the pattern observed by others. Our aim was to evaluate ethnic variation in the impact of gestational diabetes mellitus (GDM). A case-control study evaluating pregnancy outcomes was conducted in women with and without GDM from five ethnic groups. Data on GDM were collected between January 2004 and July 2017. Women giving birth between May 2013 and July 2017 in whom pre-existing diabetes had been ruled out served as controls. A multivariate logistic regression analysis was performed to determine factors independently associated with macrosomia. Overall, 852 GDM women and 3,803 controls were included. In Caucasian and East-Asian women excessive gestational weight gain (OR 2.273, 95% CI 1.364-3.788 and OR 3.776, 95% CI 0.958-14.886) was an independent predictor of macrosomia. In Latin-American and Moroccan women, obesity (OR 1.774, 95% CI 1.219-2.581 and OR 1.656, 95% CI 1.054-2.601), GDM (OR 2.440; 95% CI 1.048-5.679 and OR 3.249, 95% CI 1.269-8.321) and gestational weight gain but only for Latin-American women (OR 2.365, 95% CI 1.039-5.384) were associated with macrosomia. In South-Central Asian women, only GDM was associated with macrosomia (OR 3.701, 95% CI 1.437-9.532). GDM is an independent predictor of macrosomia in Latin-American, South-Central Asian and Moroccan women but not in Caucasian or East-Asian women in whom other factors play a more important role.

The Impact of Gestational Diabetes Mellitus on Maternal and Fetal Outcome

Objective: Gestational diabetes mellitus (GDM) is one of the major public health issues in developing countries. It occurs in 2-9 percent of all pregnancies [4-6]. The present study is aimed to determine whether maternal and neonatal outcomes in GDM women are different from those in the general obstetric population. Methods: This descriptive Observational study was conducted jointly in the departments of Obstetrics Gynecology and Medicine, Nightingale Medical College, Ashulia from 1st January 2014 to 31st December 2016 (3 years). Fifty pregnant woman diagnosed by OGTT as GDM and fifty healthy pregnant women were enrolled as study subjects. They were followed regularly at the outpatient departments until delivery for detection of maternal and fetal outcome. Results: Women with GDM were significantly older (mean age 31.5) than healthy pregnant women group (mean age 25.3). Multiparty, increased BMI and positive family history of DM were found commonly in GDM women than control group. GDM women were more prone to develop pregnancy induced hypertension (36% vs 20%), premature rupture of membrane (30% vs 14%), preterm labour (30% vs 10%) as compared to non GDM group. Rate of cesarean section was not significantly higher in GDM women than healthy women (64% vs 56%). Regarding neonatal complications there was increased risk of hyperbilirubinemia (46% vs 16%), hypoglycemia (20% vs 0) and macrosomia (30% vs 10%) in neonates of GDM women than those of non GDM women. Conclusion: Our study indicates that maternal and neonatal complications are more in GDM women than healthy population. So early detection of GDM and multidisciplinary approach of treatment in the form of dietary advice, lifestyle modification, and insulin therapy can reduce adverse outcomes without increasing the rate of cesarean section.

Varying Impact of Gestational Diabetes Mellitus on Incidence of Childhood Cancers: An Age-Stratified Retrospective Cohort Study.

We studied the association between gestational diabetes mellitus and early versus late childhood cancer. We conducted a retrospective cohort study of 1 million children born between 2006 and 2019 in Quebec, Canada. We identified children who were exposed to gestational diabetes mellitus in utero and followed them from birth up to 14 years of age to identify new-onset cancers. We estimated hazard ratios (HRs) for the association between gestational diabetes mellitus and childhood cancer using Cox proportional regression models with adjustment for covariates through inverse propensity score weights. A total of 83,626 children (8.2%) were exposed to gestational diabetes mellitus, and 1,702 developed cancer during 7.6 million person-years of follow-up. Children exposed to gestational diabetes mellitus had a higher risk of any cancer (HR 1.19, 95% CI 1.01-1.40), with signals present for blood cancer (HR 1.27, 95% CI 0.92-1.76) and solid tumors (HR 1.14, 95% CI 0.94-1.40). The association between gestational diabetes mellitus and cancer was strongest early in life and decreased with age. Gestational diabetes mellitus was associated with 1.47 times the risk of any cancer (95% CI 1.21-1.79), 1.44 times the risk of solid cancer (95% CI 1.12-1.87), and 1.61 times the risk of blood cancer (95% CI 1.09-2.36) in children age <2 years. Gestational diabetes mellitus was not significantly associated with blood or solid cancers after 2 years of age, and all associations disappeared after 6 years. Hyperglycemia may be carcinogenic in utero and may be a novel risk factor for early childhood cancer.

Comparing the course and delivery outcomes of Japanese twin pregnancies with and without gestational diabetes mellitus: a single-center retrospective analysis.

Singleton pregnant women with gestational diabetes mellitus (GDM) are at an increased risk of adverse maternal and neonatal outcomes. Multiple pregnancies are associated with increased risks of perinatal complications; however, the impact of GDM on maternal and neonatal outcomes in multiple pregnancies is unknown, and there are currently few reports on GDM status in twin pregnancies. This study aimed to compare the background and perinatal outcomes between Japanese twin pregnancies with and without GDM at a perinatal center in Japan. Additionally, the clinical course of GDM was investigated. In this retrospective cohort study, women with twin pregnancies underwent GDM screening at Yokohama City University Medical Center from January 2011 to December 2016. Overall, 307 twin pregnancies were divided into GDM (47 cases, 15.3%) and non-GDM (260 cases, 84.7%) groups. GDM-associated pregnancy complications, GDM status, and pregnancy outcomes were ascertained. Women with GDM were older and had a higher pre-pregnancy body mass index than those without GDM. Glycemic control was good in all patients, and there was no difference in delivery outcomes between the two groups. Gestational weight gain was lower in pregnant women with GDM (+8.0 kg) than in those without GDM (+11.8 kg), suggesting the impact of strict nutritional guidance on twin pregnancies with GDM. In conclusion, twin pregnancies with GDM did not have different delivery outcomes compared to those without GDM. To manage twin pregnancies with GDM, this study suggests that it is important to monitor patients' weight and blood glucose levels.

Impact of Gestational Diabetes Mellitus (GDM) on M2-Phenotype and number of human placental macrophages assessed in situ by multiplex labelling and automated image analysis

Impact of Gestational Diabetes Mellitus (GDM) on M2-Phenotype and number of human placental macrophages assessed in situ by multiplex labelling and automated image analysis

No impact of gestational diabetes mellitus on pregnancy complications in women with PCOS, regardless of GDM criteria used.

Polycystic ovary syndrome (PCOS) is characterized by the presence of insulin resistance, and women with PCOS have high prevalence of gestational diabetes (GDM). Both conditions have been associated with increased risk for pregnancy complications such as preterm birth, preeclampsia and increased offspring birth weight. We aimed to estimate the prevalence of GDM in women with PCOS using both previous and new diagnostic criteria, and to analyse whether the risk of pregnancy complications increased with the presence of GDM. In addition, we aimed to assess the response to metformin treatment in PCOS women with GDM. We performed post-hoc analysis of three prospective, double blinded studies of altogether 791 pregnant women with PCOS randomized to either metformin or placebo treatment from first trimester to delivery. Glucose data allowing GDM classification after previous (WHO 1999) and new (WHO 2013 and Norwegian 2017) diagnostic criteria were available for 722 of the women. Complications such as preeclampsia, late miscarriage and preterm birth, birth weight and gestational age were correlated to the presence of GDM and metformin treatment. The prevalence of GDM was 28.3% (WHO 1999), 41.2% (WHO 2013) and 27.2% (Norwegian 2017). Having GDM already in first trimester associated with increased risk for late miscarriage (p<0.01). Having GDM according to newer criteria correlated to increased maternal age and BMI (p<0.001). Otherwise, having GDM (any criteria) correlated neither to the development of preeclampsia, nor to birth weight z-score or the proportion of offspring being large for gestational weight. Maternal age and BMI, parity and gestational weight gain, but not GDM or metformin treatment, were determinants for birth weight z-score. Conclusion: in pregnant women with PCOS, having GDM did not increase the risk for other pregnancy complications except for an increased risk for late miscarriage among those with GDM already in the first trimester.

Risk factors for women with gestational diabetes mellitus developing type 2 diabetes and the impact on children's health.

The study aimed to explore the risk factors for progression to type 2 diabetes in women with gestational diabetes mellitus and the long-term impact of gestational diabetes mellitus on the health of their children. The occurrence of gestational diabetes mellitus in women is the strongest predictor of the development of type 2 diabetes in the future. A non-concurrent cohort and case-control study design and the guidelines forSTROBE checklist were used for the study. We reviewed medical records for the time period from the archives of the hospitals. The short-listed women and their children were invited to participate in a 'Women with gestational diabetes mellitus' research activity from November 2012-February 2016. Blood tests, physiological indicators and demographic questionnaires were applied for data collection. A total of 57 women and 57 children participated in the research activity. The risk factors for progression of gestational diabetes mellitus to type 2 diabetes included education level and the 1-h blood glucose level for the antepartum 100-g oral glucose tolerance test and the 2-h blood glucose level for the postpartum 75-g oral glucose tolerance test. However, these risk factors did not have a significant impact on the body mass index and body fat of the women's children. Healthcare providers should adopt a breadth of health education strategies to remind women with gestational diabetes mellitus to be aware of certain risk factors, and to urge them and their children to return for regular follow-up visits. Identification of the risk factors developing type 2 diabetes can make healthcare units incorporate the postpartum follow-up of gestational diabetes mellitus into their standard protocol and case managers continue to follow-up and manage the health of the women and that of their children to reduce adverse health of them.

A Clinical Study on Gestational Diabetes Mellitus and the Hearing of Newborns.

ObjectiveThis study aimed to explore the impact of gestational diabetes mellitus (GDM) on the results of newborn hearing screening.MethodsA total of 666 pregnant women who gave birth in the Obstetric Department of Sunshine Ronghe Hospital from August 2017 to May 2018 were randomly selected, and 69 of these pregnant women had GDM and were assigned into group 1 (excluding other diseases). The average age of these patients was 31.07 years. A further 597 pregnant women had no GDM and were assigned into group 2 (excluding other diseases). The average age of these patients was 30.02 years. The results of newborn hearing screening results in group 1 and group 2 were compared.ResultsComparisons of abnormal hearing screening between 2 groups are significant different (P < 0.05). In the GDM group, the results of hearing screening of newborns delivered by vaginal delivery and cesarean delivery were compared, yielding a P-value of > 0.05, and the difference was not statistically significant. In the non-GDM group, the results of hearing screening of newborns delivered by vaginal delivery and cesarean delivery were compared, yielding a P-value of >0.05, and the difference was not statistically significant.ConclusionGDM increases the incidence of abnormal hearing in newborns.