ECE2023 Eposter Presentations Diabetes, Obesity, Metabolism and Nutrition (355 abstracts)
Smoking during pregnancy is not a risk factor for gestational diabetes mellitus: A systematic review and meta-analysis
Kleoniki I. Athanasiadou 1 , Stavroula A. Paschou 1 , Evgenia Papakonstantinou 2 , Fotini Kanouta 3 , Paraskevi Kazakou 1 , Aikaterini Stefanaki 1 , Georgia N. Kassi 3 , Christothea A. Tsiridis 4 , Theodora Psaltopoulou 1 , Dimitrios Goulis 5 & Eleni Anastasiou 3
1Alexandra General Hospital, Athens, Greece, Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, Athina, Greece; 2Ippokratio General Hospital, Thessaloniki, Greece, Department of Pediatric Oncology, Thessaloniki, Greece; 3Alexandra Hospital, Athens, Greece, Department of Endocrinology, Athens, Greece; 4St. George’s, University of London, Medical School, London, United Kingdom; 5Papageorgiou General Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece, Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynaecology, Thessaloniki, Greece
Background: While the association between cigarette smoking and type 2 diabetes is established, the impact of smoking on developing gestational diabetes mellitus (GDM) remains controversial.
Aim: To investigate whether maternal cigarette smoking during pregnancy is a risk factor for developing GDM.
Methods: MEDLINE, Scopus, CENTRAL and Google Scholar databases were searched from inception to December 2022 to identify eligible original articles. A systematic review and meta-analysis (weighted data, random-effects model) were performed. The primary outcome was the development of GDM in pregnant women. The results were expressed as odds ratios (OR) with 95% confidence interval (CI) (Inverse Variance method). Subgroup analysis was planned according to the maternal smoking status and GDM diagnostic criteria. Statistical heterogeneity was checked with the Chi-squared (Chi2) test and the I2 index was used to quantify it. The studies were evaluated for publication bias. A sensitivity analysis was performed to assess the effect of each study.
Results: Thirty-five studies, including 23,849,696 pregnant women, met the inclusion criteria. The pooled OR of cigarette smoking during pregnancy compared with non-smoking (never smokers and former smokers) was 1.06 (95% CI 0.95-1.19), P=0.30; I2=90%; Chi2=344; df=34; P<0.001. Subgroup analysis was performed according to the Carpenter-Coustan GDM diagnostic criteria, due to the high heterogeneity among the other applied methods. The pooled OR for GDM for the studies that applied the Carpenter-Coustan criteria was 1.19 (95% CI 0.95-1.49), P=0.12; I2=63%; Chi2=27; df=10; P<0.002. Further subgroup analysis according to maternal smoking status was not performed due to missing data.
Conclusions: There is no evidence to support an association between maternal cigarette smoking during pregnancy and the risk for GDM. Universally accepted diagnostic criteria for GDM must be adopted to reduce heterogeneity and clarify the association between smoking and GDM.
Keywords: gestational diabetes mellitus; GDM; cigarette smoking; tobacco; pregnancy; perinatal
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Endocrine Abstracts
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