Cohort Profile: The Finnish Gestational Diabetes (FinnGeDi) Study

Keikkala, Elina; Mustaniemi, Sanna; Koivunen, Sanna; Viljakainen, Matti; Männistö, Tuija; Ijäs, Hilkka; Pouta, Anneli; Kaaja, Risto; Eriksson, Johan G.; Laivuori, Hannele; Gissler, Mika; Erkinheimo, Tiina-Liisa; Keravuo, Ritva; Metsälä, Jenni; Stach‐Lempinen, Beata; Klemetti, Miira M.; Tikkanen, Minna; Kajantie, Eero; Vääräsmäki, Marja

doi:10.1093/ije/dyaa039

Cited by 23 publications

(27 citation statements)

References 20 publications

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“…The present multicenter case-control study is based on the clinical-genetic arm of the Finnish Gestational Diabetes Study (FinnGeDi), which has been described in detail (12,13). Briefly, 1,146 women with singleton pregnancies diagnosed with GDM were recruited in delivery units before delivery, and the next consenting non-diabetic mother (n = 1,066) giving birth in the same hospital was recruited as a control.…”

Section: Methodsmentioning

confidence: 99%

Normal Gestational Weight Gain Protects From Large-for-Gestational-Age Birth Among Women With Obesity and Gestational Diabetes

Mustaniemi

Nikkinen

Bloigu

et al. 2021

Front. Public Health

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Background: Pre-pregnancy obesity, excess gestational weight gain (GWG), and gestational diabetes (GDM) increase fetal growth. Our aim was to assess whether normal GWG is associated with lower risk for a large-for-gestational-age (LGA; over the 90th percentile of birth weight for sex and gestational age) infant and lower birth weight standard deviation (SD) score in the presence of GDM and maternal obesity.Methods: This multicenter case-control study is part of the Finnish Gestational Diabetes (FinnGeDi) Study and includes singleton pregnancies of 1,055 women with GDM and 1,032 non-diabetic controls. Women were divided into 12 subgroups according to their GDM status, pre-pregnancy body mass index (BMI; kg/m2), and GWG. Non-diabetic women with normal BMI and normal GWG (according to Institute of Medicine recommendations) served as a reference group.Results: The prevalence of LGA birth was 12.2% among women with GDM and 6.2% among non-diabetic women (p < 0.001). Among all women, normal GWG was associated with lower odds of LGA [odds ratio (OR) 0.57, 95% CI: 0.41–0.78]. Among women with both obesity and GDM, the odds for giving birth to a LGA infant was 2.25-fold (95% CI: 1.04–4.85) among those with normal GWG and 7.63-fold (95% CI: 4.25–13.7) among those with excess GWG compared with the reference group. Compared with excess GWG, normal GWG was associated with 0.71 SD (95% CI: 0.47–0.97) lower birth weight SD score among women with GDM and obesity. Newborns of normal weight women with GDM and normal GWG had 0.28 SD (95% CI: 0.05–0.51) lower birth weight SD scores compared with their counterparts with excess GWG. In addition, in the group of normal weight non-diabetic women, normal GWG was associated with 0.46 SD (95% CI: 0.30–0.61) lower birth weight SD scores compared with excess GWG.Conclusion: GDM, obesity, and excess GWG are associated with higher risk for LGA infants. Interventions aiming at normal GWG have the potential to lower LGA rate and birth weight SD scores even when GDM and obesity are present.

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Section: Methodsmentioning

confidence: 99%

Normal Gestational Weight Gain Protects From Large-for-Gestational-Age Birth Among Women With Obesity and Gestational Diabetes

Mustaniemi

Nikkinen

Bloigu

et al. 2021

Front. Public Health

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“…We designed a case-control study as part of the FinnGeDi prospective multicenter case-control cohort, including a total of 1,072 participants (536 mother-offspring pairs), of whom 298 (55.6%) had GDM during pregnancy. As described in detail ( 13 ), women with GDM were recruited from delivery units when arriving to give birth, and the next woman without GDM was recruited as a control. Maternal venous blood and offspring cord blood samples were collected during delivery.…”

Section: Methodsmentioning

confidence: 99%

“…Despite the relatively large meta-analysis sample size, the authors did not observe any individual cord-blood CpG probes associated with GDM exposure using the false discovery rate (FDR) for testing significance (12). Here, we used the Finnish Gestational Diabetes (FinnGeDi) study cohort of 298 mother-offspring pairs with GDM and 238 without, all with maternal blood and cord blood samples (13), in order to investigate whether epigenetic changes occur in response to GDM exposure during pregnancy, both in mothers and their offspring. Specifically, we tested two hypotheses, whether exposure to GDM is associated with: 1) epigenetic changes shared by mother and offspring pairs and 2) specific epigenetic changes in the offspring.…”

Section: Introductionmentioning

confidence: 99%

Epigenome-Wide Association Study Reveals Methylation Loci Associated With Offspring Gestational Diabetes Mellitus Exposure and Maternal Methylome

et al. 2021

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Objective: Gestational diabetes mellitus (GDM) is associated with a future offspring risk for the development of obesity and insulin resistance in Gestational diabetes mellitus (GDM) is associated with an increased risk of obesity and insulin resistance in offspring later in life, which might be explained by epigenetic changes in response to maternal hyperglycaemic exposure. Research Design and Methods:We explored the association of GDM exposure on maternal blood and newborn cord-blood methylation of 536 mother-offspring pairs from the prospective FinnGeDi cohort, using Illumina's methylationEPIC BeadChip 850K arrays. We assessed two hypotheses First, we tested for shared maternal and offspring epigenetic effects due to GDM exposure. Second, we tested whether GDM exposure and maternal methylation has an epigenetic effect on the offspring. Results:We did not find any epigenetic marks (differentially methylated CpG probes) with shared and consistent effects between mothers and offspring. After including maternal methylation in the model, we identified a single significant (FDR = 1.38 x 10 -2 ) CpG at the cg22790973 probe (TFCP2) associated with GDM. We identified seven additional FDR-significant interactions of maternal methylation and GDM status, with the strongest association at the same cg22790973 probe (TFCP2), plus cg03456133, cg24440941 (H3C6), cg20002843 (LOC127841), cg19107264, cg11493553 located in the UBE3C gene and cg17065901 in FAM13A, both susceptibility genes for type 2 diabetes and BMI and cg23355087, within the DLGAP2 gene, known to be involved in insulin resistance during pregnancy. Conclusion:Our study reveals the potential complexity of the epigenetic transmission between GDM mothers and their offspring, likely determined by not only GDM

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“…Only a limited number of mother-child cohorts with focus on gestational diabetes exist worldwide, ranging from large register studies [50,51] over prospective studies [30,[52][53][54] to case-control studies [50] and to follow up studies of randomized clinical trials for the prevention of GDM with lifestyle intervention early in pregnancy [55]. Though, the PREG study covers crucial aspects that are not comprehensively addressed in other larger trials so far.…”

Section: Discussion and Outlookmentioning

confidence: 99%

The German Gestational Diabetes Study (PREG): Rationale, Methodology and Design

Fritsche

Hummel

Wagner

et al. 2021

Preprint

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Since the introduction of the new International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria for gestational diabetes mellitus (GDM) in 2012, diagnosis and treatment of GDM has improved. But even well-treated GDM might still have impact on long-term health of the mother and her offspring, though, this relation has not been conclusively studied yet. The multicenter PREG study is designed to metabolically and phenotypically characterize women with a 75 g five-point oral glucose tolerance test (OGTT) during and repeatedly after pregnancy. The offspring of the study participants are followed up until adulthood with developmental tests and metabolic and epigenetic phenotyping in the PREG offspring study. By in-depth phenotyping of the mother and her offspring, we aim to elucidate the relationship of maternal hyperglycemia during pregnancy and adequate treatment and its impact on the long-term health for both.

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Cohort Profile: The Finnish Gestational Diabetes (FinnGeDi) Study

Cited by 23 publications

References 20 publications

Normal Gestational Weight Gain Protects From Large-for-Gestational-Age Birth Among Women With Obesity and Gestational Diabetes

Normal Gestational Weight Gain Protects From Large-for-Gestational-Age Birth Among Women With Obesity and Gestational Diabetes

Epigenome-Wide Association Study Reveals Methylation Loci Associated With Offspring Gestational Diabetes Mellitus Exposure and Maternal Methylome

The German Gestational Diabetes Study (PREG): Rationale, Methodology and Design

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