Endocrine Abstracts

Introduction: Gestational diabetes mellitus (GDM) is a common complication of pregnancy. Identification of early determinants of GDM is necesary to designate possible preventive strategies. The aim of this study was to reveal the most significant risk factors for GDM.

Design: A total of 209 women with singleton pregnancies were included in the study. Maternal fasting glucose, anthropometric parameters and blood pressure were measured in the first trimester of pregnancy. Pregnant women were screened for GDM between weeks 24 and 28 of gestation, as defined by WHO criteria. Classification Tree Method was used to identify combination of early pregnancy risk factors that predict the highest risk of the development of GDM in later pregnancy.

Results: An age ≧ 35 years in combination with a fasting glucose level ≧ 4.8 mmol/L and a body mass index (BMI) ≧ 28.5 kg/m² in the first trimester was associated with 89% risk of two-hour glucose ≧7.8 mmol/L following the 75-g oral glucose tolerance test (odds ratio [OR] 15.7, 95% CI 1.8 - 130.6, P=0.002). In women aged less that 35 with the combination of a first trimester BMI 28.5 kg/m² with a level of fasting glycemia 4.8 mmol/L and hypertension (blood pressure ≧140 and/or ≧90 mmHg or use of antihypertensive medications) the absolute risk of the development of GDM was 75% and OR was 6.3, 95% CI 1.9- 20.6, P=0.001.

Conclusions: Advanced maternal age, higher BMI, higher fasting glycemia and hypertension in the first trimester predict increased GDM risk. Taking these combinations into consideration may facilitate the identification of women at particular risk for GDM and suggest potential strategies for reducing this risk.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This work was supported, however funding details unavailable.