Glucose Intolerance in Pregnancy and Postpartum Risk of Metabolic Syndrome in Young Women

Retnakaran, Ravi; Qi, Ying; Connelly, Philip W.; Sermer, Mathew; Zinman, Bernard; Hanley, Anthony J.

doi:10.1210/jc.2009-1990

Cited by 175 publications

(156 citation statements)

References 36 publications

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“…These studies highlight the chronic nature of the metabolic dysfunction associated with GDM. Furthermore, they raise the possibility that a diagnosis of GDM may indicate the presence of an underlying latent metabolic syndrome (Retnakaran et al, 2010b).…”

Section: Development Of Metabolic Syndrome After Gdmmentioning

confidence: 99%

Gestational Diabetes and the Metabolic Syndrome

Souza¹,

Ray²,

Retnakaran³

2011

Gestational Diabetes

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Section: Development Of Metabolic Syndrome After Gdmmentioning

confidence: 99%

Gestational Diabetes and the Metabolic Syndrome

Souza¹,

Ray²,

Retnakaran³

2011

Gestational Diabetes

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“…Introduction P regnancy complications, including gestational diabetes, [1][2][3][4][5] hypertension in pregnancy, [6][7][8][9][10] low birthweight, [11][12][13] and preterm delivery, 12,14 are risk factors for developing cardiovascular disease (CVD) later in life. [15][16][17][18] The 2011 American Heart Association (AHA) ''Guidelines for the Prevention of Cardiovascular Disease in Women'' recommended that healthcare providers take a history of these pregnancies to identify women whose pregnancy history places them at increased risk for future CVD.…”

mentioning

confidence: 99%

Pregnancy Complications as Markers for Subsequent Maternal Cardiovascular Disease: Validation of a Maternal Recall Questionnaire

Carter

Stuart

Farland

et al. 2015

Journal of Women's Health

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Background: We designed and tested the validity of a questionnaire to characterize maternal recall of pregnancy complications associated with increased future cardiovascular disease risk, based on the 2011 American Heart Association (AHA) guidelines. Methods: A maternal recall questionnaire of pregnancy history was administered to 971 patients who had participated in a previous cohort study of 1,608 pregnant women. Medical records from the study pregnancy served as the gold standard. Prevalence, sensitivity (sens), specificity (spec), positive predictive value (PPV), negative predictive value (NPV), and/or Spearman's correlation coefficients (r) were calculated for each question. Results: A total of 526 (54%) individuals recontacted responded. Respondents were more likely to be older, white, educated, and nulliparous and were less likely to deliver low-birthweight infants in the study pregnancy than were individuals who did not respond. Mean length of recall was 4.35 years (standard deviation [SD] 0.46) postpartum. Maternal recall was most accurate for gestational diabetes (sens: 92%, spec: 98%, PPV: 79%, NPV: 99%), infant birthweight (r = 0.95), and gestation length (r = 0.85). Maternal recall was modest for preeclampsia (sens: 79%, spec: 97%, PPV: 68%, NPV: 98%) and pregnancy-associated hypertension, including preeclampsia or gestational hypertension (sens: 60%, spec: 95%, PPV: 64%, NPV: 94%).Conclusions: This validation study demonstrated that the majority of women could accurately recall a history of gestational diabetes, infant birthweight, and gestational age at delivery, 4 years postpartum on average. Recall of preeclampsia and pregnancy-associated hypertension overall was modest. Maternal report of these pregnancy conditions may help clinicians identify women at increased risk for cardiovascular disease.

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“…Women with GDM have been reported to have increased rates of stillbirth, polyhydramnios, gestational hypertension, macrosomia, and cesarean delivery (9). GDM usually resolves after delivery, but it appears that the risk of recurring GDM and type 2 diabetes mellitus are increased in subsequent pregnancies, along with cardiovascular risk later in life (10,11). Although the precise role of the risk factors related to GDM (multiparity, obesity,) has not yet been entirely defined, they may be included in the classification of pregnancy-related or maternal factors (12).…”

Section: Discussionmentioning

confidence: 99%

Gestational diabetes mellitus screening and outcomes

Aktun

Uyan

Yorgunlar

et al. 2015

J Turkish German Gynecol Assoc

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Results: Approximately 28% of the pregnant women aged younger than 35 years with no risk factors for gestational diabetes mellitus were diagnosed with the oral glucose tolerance test in this study. In the gestational diabetes mellitus group, the primary cesarean section rate was importantly higher than that in the non-gestational diabetes mellitus group. Preterm delivery was also associated with gestational diabetes mellitus. The diagnosis of gestational diabetes mellitus was strongly associated with admittance to the neonatal intensive care unit. Neonatal respiratory problems didn't showed any significant deviation between the groups. There was a moderate association between gestational diabetes mellitus and metabolic complications. Conclusion:Pregnant women with no obvious risk factors were diagnosed with gestational diabetes mellitus using the World Health Organization criteria. The treatment of these women potentially reduced their risk of adverse maternal and neonatal hyperglycemia-related events, such as cesarean section, polyhydramnios, preterm delivery, admission to neonatal intensive care unit, large for gestational age, and higher neonatal weight. (J Turk Ger Gynecol Assoc 2015; 16: 25-9) Keywords: Gestation, diabetes mellitus, pregnancy, oral glucose tolerance test, neonatal outcomes Received: 25 July, 2014 Accepted: 10 January, 2015 Gestational diabetes mellitus screening and outcomesHale Lebriz Aktün, Derya Uyan, Betül Yorgunlar, Mustafa Acet Department of Obstetrics and Gynecology, İstanbul Medipol University Hospital, İstanbul, Turkey AbstractOriginal Investigation 25 treatment with self-observing of blood glucose levels (fasting and 1 h after each meal) daily with a glucometer. Subsequent follow-ups were conducted for all patients biweekly or more frequently as indicated. Treatment outcomes were evaluated according to the American Diabetes Association recommendations (6). All demographic characteristics (age, parity, family history of diabetes, and self-reported prepregnancy weight) of the patients were obtained from their existing records. Birth mode (cesarean or vaginal delivery) and labor induction, preterm delivery (delivery before 37 weeks of gestation), gestational hypertension, preeclampsia, polyhydramnios, and oligohydramnios were also documented from these records. The recorded adverse fetal outcomes were infant death, stillbirth, dystocia, bone fracture, nerve palsy, admission to the neonatal intensive care unit (NICU), respiratory complications [including respiratory distress syndrome (RDS) and transient tachypnea of newborn (TTN)] that increased birth weight, macrosomy (birth weight of >4000 g), large for gestational age (LGA, defined as birth weight> the 90 th percentile on standard charts), small for gestational age (SGA, defined as birth weight < the 10 th percentile on standard charts), and metabolic complications including hypocalcemia, hemoglobin level ≥20 g/dL, hypoglycemia (blood glucose level ≤35 mg/dL), and hyperbilirubinemia requiring phototherapy. ResultsThe pr...

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Glucose Intolerance in Pregnancy and Postpartum Risk of Metabolic Syndrome in Young Women

Abstract: Both GDM and mild glucose intolerance in pregnancy predict an increased likelihood of metabolic syndrome at 3 months postpartum, supporting the concept that women with gestational dysglycemia may have an underlying latent metabolic syndrome.

Cited by 175 publications

References 36 publications

Gestational Diabetes and the Metabolic Syndrome

Gestational Diabetes and the Metabolic Syndrome

Pregnancy Complications as Markers for Subsequent Maternal Cardiovascular Disease: Validation of a Maternal Recall Questionnaire

Gestational diabetes mellitus screening and outcomes

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