Gestational diabetes in primiparous women–impact of age and adiposity: a register‐based cohort study

Laine, Merja K.; Kautiainen, Hannu; Gissler, Mika; Raina, Marko; Aahos, Ilkka; Järvinen, Kajsa; Pennanen, Pirjo; Eriksson, Johan G.

doi:10.1111/aogs.13271

Cited by 39 publications

(36 citation statements)

References 30 publications

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“…The high incidence of GDM in our Brazilian cohort is not surprising. In a recent study conducted in Finland, 16.5% of the nulliparous women evaluated were diagnosed with gestational diabetes [10]. This result is in line with our findings, but lower rates have also been reported.…”

Section: Discussionsupporting

confidence: 92%

“…However, the prevalence of overweight and obesity epidemic in women of childbearing age contributes to a higher risk of GDM [20,[21][22][23][24]. Only few studies have actually reported risk factors for GDM in nulliparous women [10][11][12]25]. In Brazilian nulliparous women, these risk factors have still not been published.…”

Section: Discussionmentioning

confidence: 99%

“…The identification of risk factors in a particular population of pregnant women, along with a well-defined diagnostic protocol, may improve the performance of risk factors in predicting HIP (DIP or GDM). Although several studies have previously identified classical risk factors for GDM, relatively few studies have been conducted in nulliparous women [10][11][12], and none were focused on Brazilian healthy nulliparous women. Our objective was to assess the incidence and risk factors for HIP (DIP or GDM) in a cohort of Brazilian nulliparous pregnant women.…”

Section: Introductionmentioning

confidence: 99%

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Incidence and risk factors for hyperglycemia in pregnancy among nulliparous women: A Brazilian multicenter cohort study

et al. 2020

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Objective To assess the incidence and risk factors for hyperglycemia in pregnancy in a cohort of Brazilian nulliparous pregnant women. Materials and methods This is a secondary analysis of a multicenter cohort study that enrolled 1,008 nulliparous pregnant women at 19-21 weeks. Exclusion criteria included chronic exposure to corticosteroids and previous diabetes. Bivariate and multivariate analyses by Poisson regression were used to identify associated factors. Results The incidence of hyperglycemia in pregnancy was 14.9% (150/1,008), and 94.7% of these cases were gestational diabetes mellitus (142/150). Significant associated factors included a family history of diabetes mellitus, maternal overweight or obesity at enrollment, and previous maternal conditions (polycystic ovarian syndrome, thyroid dysfunctions and hypertensive disorders). A BMI � 26.3Kg/m 2 (RR adj 1.87 [1.66-2.10]) and a family history of diabetes mellitus (RR adj 1.71 [1.37-2.15]) at enrollment were independent risk factors for HIP. Conclusions A family history of diabetes mellitus and overweight or obesity (until 19-21 weeks of gestation) may be used as selective markers for HIP in Brazilian nulliparous women. Given the

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Incidence and risk factors for hyperglycemia in pregnancy among nulliparous women: A Brazilian multicenter cohort study

et al. 2020

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“…During the study period, between the years 2009 and 2015 in Finland, the nationwide incidence of GDM, including both primiparous and multiparous women, increased from 9% to 16% . Our study observation of a high GDM incidence is in line with nationwide data, as well as with previous findings from the same study cohort . The comprehensive screening for GDM according to the Finnish Current Care Guidelines for GDM since 2008 probably explains our high incidence of GDM in these primiparous Finnish women .…”

Section: Discussionsupporting

confidence: 91%

Impact of maternal income on the risk of gestational diabetes mellitus in primiparous women

et al. 2019

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Aims Findings concerning the impact of socio‐economic status on the risk of gestational diabetes mellitus (GDM) are inconclusive and little is known about the simultaneous impact of income and educational attainment on the risk of GDM. This study aims to assess the impact of maternal prepregnancy income in combination with traditional GDM risk factors on the incidence of GDM in primiparous women. Methods This is an observational cohort study including 5962 Finnish women aged ≥ 20 years from the city of Vantaa, Finland, who delivered for the first time between 2009 and 2015, excluding women with pre‐existing diabetes mellitus. The Finnish Medical Birth Register, Finnish Tax Administration, Statistics Finland, Social Insurance Institution of Finland and patient healthcare records provided data for the study. We divided the study population according to five maternal income levels and four educational attainment levels. Results Incidence of GDM decreased with increasing income level in primiparous women (P < 0.001 for linearity, adjusted for smoking, age, BMI and cohabiting status). In an adjusted two‐way model, the relationship was significant for both income (P = 0.007) and education (P = 0.039), but there was no interaction between income and education (P = 0.52). Conclusions There was an inverse relationship between both maternal prepregnancy taxable income and educational attainment, and the risk of GDM in primiparous Finnish women.

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“…Hyperglycemia in pregnancy (HGiP) is a major cause of complications in pregnancy. The growing rates of obesity, polycystic ovary syndrome (PCOS), and advanced maternal age in women of childbearing age have contributed to the increased prevalence of HGiP . Changed diagnostic pathways and more stringent diagnostic criteria have also led to a substantial increase in the number of women diagnosed with HGiP …”

Section: Introductionmentioning

confidence: 99%

Changing environment of hyperglycemia in pregnancy: Gestational diabetes and diabetes mellitus in pregnancy

Gray

Sweeting

McGuire

et al. 2018

Journal of Diabetes

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The diagnosis and treatment of gestational diabetes mellitus (GDM) have been in a state of flux since the World Health Organization accepted and endorsed the International Diabetes and Pregnancy Study Group's diagnostic pathway and criteria in 2013. These new diagnostic criteria identify an increasing number of women at risk of hyperglycemia in pregnancy (HGiP). Maternal hyperglycemia represents a significant risk to the mother and fetus, in both the short and long term. Controversially, metformin use for the treatment of GDM is increasing in Australia. This article identifies the multiple and varied presentations of HGiP, of which GDM is the most commonly encountered. The degree of maternal hyperglycemia experienced affects the outcomes for both the mother and neonate, and specific diagnosis determines the appropriate treatment for the pregnancy. Given the increasing incidence of women with dysglycemia and those developing HGiP, this is an important area for research and clinical attention for all health professionals.

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Gestational diabetes in primiparous women–impact of age and adiposity: a register‐based cohort study

Abstract: The prevalence of GDM is high in primiparous women. Both age and degree of adiposity influenced the risk for GDM. To reduce GDM risk, adiposity should be prevented already in childhood and primiparity should be encouraged at a younger age.

Cited by 39 publications

References 30 publications

Incidence and risk factors for hyperglycemia in pregnancy among nulliparous women: A Brazilian multicenter cohort study

Incidence and risk factors for hyperglycemia in pregnancy among nulliparous women: A Brazilian multicenter cohort study

Impact of maternal income on the risk of gestational diabetes mellitus in primiparous women

Changing environment of hyperglycemia in pregnancy: Gestational diabetes and diabetes mellitus in pregnancy

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