Difference in prevalence of gestational diabetes and perinatal outcome in an innercity multiethnic London population

Koukkou, E; Taub, Nicholas; Jackson, Pearce; Metcalfe, G. A.; Cameron, M; Lowy, C.

doi:10.1016/0028-2243(95)02043-r

Cited by 29 publications

(24 citation statements)

References 21 publications

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“…In addition, prevalences of both IGT (1.5%) and GDM (3.7%) were lower among blacks than whites (IGT 3.4%, GDM 5.9%). This is in contrast to previously published rates of GDM in blacks, which were slightly higher than whites of the same study population (10,11).…”

Section: Discussioncontrasting

confidence: 56%

The Association Between Impaired Glucose Tolerance and Birth Weight Among Black and White Women in Central North Carolina

et al. 2003

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OBJECTIVE -This study examines the relationship of glucose intolerance during pregnancy to birth weight among black and white participants of the Pregnancy, Infection, and Nutrition Study.RESEARCH DESIGN AND METHODS -This prospective cohort study recruited women from prenatal clinics in central North Carolina at 24 -29 weeks' gestation. A 1-h 50-g glucose challenge test (GCT) and 100-g oral glucose tolerance test (OGTT) were conducted. Impaired glucose tolerance (IGT) was defined as one high value on the OGTT, gestational diabetes mellitus (GDM) as two or more high values, and normal glucose tolerance (NGT) was defined as a low or high value on the GCT screen but no high values on the OGTT. Women with known glucose status and birth outcome information were included in this analysis (n ϭ 2055).RESULTS -Black women with IGT had higher rates of both macrosomia (38.5%) and large for gestational age (LGA) (53.9%) compared with white women (10.0% and 13.2%). Black infants' birth weights (3,800 g) and prevalence of macrosomia and LGA were significantly higher among mothers with IGT compared with NGT women (birth weight, 3,184 g; macrosomia, 7.0%; LGA, 11.6%). In contrast, among white infants, there was no significant increase in birth weight, macrosomia, or LGA associated with the mother's glucose tolerance status. In addition, there was no effect of GDM on birth weight in either group.CONCLUSIONS -This study suggests that, independent of maternal prepregnant weight, there may be significant increased risk of macrosomia among black IGT women but not among white IGT women. Further investigations into factors that may contribute to the observed results are needed. Diabetes Care 26:656 -661, 2003

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Section: Discussioncontrasting

confidence: 56%

The Association Between Impaired Glucose Tolerance and Birth Weight Among Black and White Women in Central North Carolina

et al. 2003

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“…Findings from Rey et al (46) suggested that mild carbohydrate intolerance was also associated with higher rates of neonatal hypoglycemia and hyperbilirubinemia. Other studies, however, showed an insignificant increase in morbidity in the offspring of mothers with GDM, especially those with IGT or mild glucose intolerance (4,32). The current study showed that asphyxia and hypoglycemia were similar in the two groups.…”

Section: Methodscontrasting

confidence: 52%

“…Studies have failed to show relationships between perinatal morbidity and impaired glucose tolerance (IGT) during pregnancy (1)(2)(3)(4) or gestational diabetes mellitus (GDM) (5). Randomized controlled clinical trials, available to date, have not shown any significant effect of the treatment of GDM on pregnancy outcomes (6,7).…”

mentioning

confidence: 99%

Women With Impaired Glucose Tolerance During Pregnancy Have Significantly Poor Pregnancy Outcomes

Yang

Hsu-Hage

Zhang³

et al. 2002

Diabetes Care

166

102

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OBJECTIVE -This article tests the hypothesis that women with impaired glucose tolerance (IGT) have the same pregnancy outcomes as those of their counterparts with normal glucose tolerance. RESEARCH DESIGN AND METHODS-From December 1998 to December 1999, 84 of 90 antenatal care base units (ACBUs) under the Tianjin Antenatal Care Network in China participated in the first screening program for gestational diabetes mellitus (GDM). A total of 9,471 pregnant women under the care of participating ACBUs were screened. Of the women screened, 154 were positive for IGT. Of the 154 women, 102 opted for conventional obstetric care. The comparison group was 302 women of normal glucose tolerance (NGT). The initial screening consisted of a 50-g 1-h glucose test, and was carried out at 26 -30 gestational weeks. Women with a serum glucose Ն7.8 mmol/l were followed up with a 75-g 2-h oral glucose tolerance test. The World Health Organization's diagnostic criteria for GDM were used.RESULTS -Women with IGT were at increased risk for premature rupture of membranes (P-ROM) (odds ratio [OR] 10.07; 95% CI 2.90 -34.93); preterm birth (6.42; 1.46 -28.34); breech presentation (3.47; 1.11-10.84); and high birth weight (90th percentile or 4,000 g) (2.42; 1.07-5.46); adjusting for maternal age, pregravid BMI, hospital levels, and other confounding factors.CONCLUSIONS -The presence of IGT in pregnancy is predictive of poor pregnancy outcomes.

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“…The role of maternal obesity in fetal overnutrition is supported by results from a Danish study in which offspring of women with type 2 diabetes risk factors (obesity and family In the absence of universal screening for gestational diabetes with oral glucose tolerance tests in this study population, it is likely that some of women with glycosuria would fulfil current criteria for a diagnosis of gestational diabetes. This is supported by the low prevalence of gestational diabetes (0.4%) in this study sample compared with prevalences of 1.2% and 1.8% among UK women who were screened, for research purposes, with fasting glucose and/or oral glucose tolerance tests, respectively, in the early 1990s [31,32]. Women with glycosuria (who were not diagnosed with gestational diabetes) will not have been treated in any way to reduce their glycaemia and therefore fetal overnutrition may have occurred.…”

Section: Discussionmentioning

confidence: 66%

Association of existing diabetes, gestational diabetes and glycosuria in pregnancy with macrosomia and offspring body mass index, waist and fat mass in later childhood: findings from a prospective pregnancy cohort

et al. 2009

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Aims/hypothesis The aim of the study was to examine the association of existing diabetes (i.e. already diagnosed prior to pregnancy), gestational diabetes and glycosuria (both diagnosed and ascertained during pregnancy) with birthweight and future offspring BMI, waist circumference and fat mass (assessed by dual x-ray emission absorptiometry).Methods A prospective pregnancy/birth cohort study was performed using data from the Avon Longitudinal Study of Parents and Children. Results Among 10,591 mother-offspring pairs included in analyses with birth size, women with existing diabetes (n=40), those diagnosed with gestational diabetes (n=53) and those with at least two episodes of ++ glycosuria (n=372) had greater mean birthweight and odds for macrosomia (birthweight>4,000 g) than women with none of these. Adjusted odds ratios for macrosomia were 3.56 (95%CI 1.53-8.28), 5.50 (95%CI 1.18-10.30) and 1.58 (95%CI 1.18-2.12) for existing diabetes, gestational diabetes and glycosuria, respectively. Among 6,842 motheroffspring pairs with anthropometric measurements at age 9-11 years, maternal gestational diabetes and glycosuria (but not existing diabetes) were associated with increased offspring odds of general or central overweight/obesity. For gestational diabetes, these associations attenuated towards the null with adjustment for maternal prepregnancy BMI, but independent associations remained for glycosuria. The adjusted odds ratio for general overweight/obesity when comparing women with at least two episodes of ++ glycosuria with those with no evidence of diabetes or glycosuria was 1.35 (95%CI 1.00-1.82) and that for central obesity (top 10% waist circumference vs all others) was 1.31 (95%CI 1.00-1.72). Conclusions/interpretation These results provide some evidence for a long-term effect of maternal glycaemia in pregnancy on offspring obesity risk.

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Difference in prevalence of gestational diabetes and perinatal outcome in an innercity multiethnic London population

Cited by 29 publications

References 21 publications

The Association Between Impaired Glucose Tolerance and Birth Weight Among Black and White Women in Central North Carolina

The Association Between Impaired Glucose Tolerance and Birth Weight Among Black and White Women in Central North Carolina

Women With Impaired Glucose Tolerance During Pregnancy Have Significantly Poor Pregnancy Outcomes

Association of existing diabetes, gestational diabetes and glycosuria in pregnancy with macrosomia and offspring body mass index, waist and fat mass in later childhood: findings from a prospective pregnancy cohort

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