Risk factors for hyperglycemia in pregnancy in the DALI study differ by period of pregnancy and OGTT time point

behalf of the DALI Core Investigator Group

doi:10.1530/eje-18-0003

Risk factors for hyperglycemia in pregnancy in the DALI study differ by period of pregnancy and OGTT time point

behalf of the DALI Core Investigator Group

Department of Clinical Medicine

8 Citations (Scopus)

Abstract

Objective: Risk factors are widely used to identify women at risk for gestational diabetes mellitus (GDM) without clear distinction by pregnancy period or oral glucose tolerance test (OGTT) time points. We aimed to assess the clinical risk factors for Hyperglycemia in pregnancy (HiP) differentiating by these two aspects. Design and methods: Nine hundred seventy-one overweight/obese pregnant women, enrolled in the DALI study for preventing GDM. OGTTs were performed at ≤19 + 6, 24–28 and 35–37 weeks (IADPSG/WHO2013 criteria). Women with GDM or overt diabetes at one time point did not proceed to further OGTTs. Potential independent variables included baseline maternal and current pregnancy characteristics. Statistical analysis: Multivariate logistic regression. Results: Clinical characteristics independently associated with GDM/overt diabetes were at ≤19 + 6 weeks, previous abnormal glucose tolerance (odds ratio (OR): 3.11; 95% CI: 1.41–6.85), previous GDM (OR: 2.22; 95% CI: 1.20–4.11), neck circumference (NC) (OR: 1.58; 95% CI: 1.06–2.36 for the upper tertile), resting heart rate (RHR, OR: 1.99; 95% CI: 1.31–3.00 for the upper tertile) and recruitment site; at 24–28 weeks, previous stillbirth (OR: 2.92; 95% CI: 1.18-7.22), RHR (OR: 3.32; 95% CI: 1.70-6.49 for the upper tertile) and recruitment site; at 35–37 weeks, maternal height (OR: 0.41; 95% CI: 0.20–0.87 for upper tertile). Clinical characteristics independently associated with GDM/overt diabetes differed by OGTT time point (e.g. at ≤19 + 6 weeks, NC was associated with abnormal fasting but not postchallenge glucose). Conclusion: In this population, most clinical characteristics associated with GDM/overt diabetes were non-modifiable and differed by pregnancy period and OGTT time point. The identified risk factors can help define the target population for future intervention trials.

Original language	English
Journal	European Journal of Endocrinology
Volume	179
Issue number	1
Pages (from-to)	39-49
Number of pages	11
ISSN	0804-4643
DOIs	https://doi.org/10.1530/eje-18-0003
Publication status	Published - 2018

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@article{276fcb95f6544e6ab651bedb0bd20467,

title = "Risk factors for hyperglycemia in pregnancy in the DALI study differ by period of pregnancy and OGTT time point",

abstract = "Objective: Risk factors are widely used to identify women at risk for gestational diabetes mellitus (GDM) without clear distinction by pregnancy period or oral glucose tolerance test (OGTT) time points. We aimed to assess the clinical risk factors for Hyperglycemia in pregnancy (HiP) differentiating by these two aspects. Design and methods: Nine hundred seventy-one overweight/obese pregnant women, enrolled in the DALI study for preventing GDM. OGTTs were performed at ≤19 + 6, 24–28 and 35–37 weeks (IADPSG/WHO2013 criteria). Women with GDM or overt diabetes at one time point did not proceed to further OGTTs. Potential independent variables included baseline maternal and current pregnancy characteristics. Statistical analysis: Multivariate logistic regression. Results: Clinical characteristics independently associated with GDM/overt diabetes were at ≤19 + 6 weeks, previous abnormal glucose tolerance (odds ratio (OR): 3.11; 95% CI: 1.41–6.85), previous GDM (OR: 2.22; 95% CI: 1.20–4.11), neck circumference (NC) (OR: 1.58; 95% CI: 1.06–2.36 for the upper tertile), resting heart rate (RHR, OR: 1.99; 95% CI: 1.31–3.00 for the upper tertile) and recruitment site; at 24–28 weeks, previous stillbirth (OR: 2.92; 95% CI: 1.18-7.22), RHR (OR: 3.32; 95% CI: 1.70-6.49 for the upper tertile) and recruitment site; at 35–37 weeks, maternal height (OR: 0.41; 95% CI: 0.20–0.87 for upper tertile). Clinical characteristics independently associated with GDM/overt diabetes differed by OGTT time point (e.g. at ≤19 + 6 weeks, NC was associated with abnormal fasting but not postchallenge glucose). Conclusion: In this population, most clinical characteristics associated with GDM/overt diabetes were non-modifiable and differed by pregnancy period and OGTT time point. The identified risk factors can help define the target population for future intervention trials.",

author = "Mendoza, {Lilian C.} and J{\"u}rgen Harreiter and David Simmons and Gernot Desoye and Adelantado, {J. M.} and Fabiola Juarez and Ana Chico and Roland Devlieger and {Van Assche}, Andre and Sander Galjaard and Peter Damm and Mathiesen, {Elisabeth R.} and Jensen, {Dorte M.} and Andersen, {Lise Lotte T.} and Mette Tanvig and Annunziata Lapolla and Dalfra, {Maria G.} and Alessandra Bertolotto and Urszula Mantaj and Ewa Wender-Ozegowska and Agnieszka Zawiejska and David Hill and Jelsma, {Judith G.} and Snoek, {Frank J.} and {Van Poppel}, {Mireille N.M.} and Christof Worda and Dagmar Bancher-Todesca and Alexandra Kautzky-Willer and Dunne, {Fidelma P.} and Rosa Corcoy and {behalf of the DALI Core Investigator Group}",

year = "2018",

doi = "10.1530/eje-18-0003",

language = "English",

volume = "179",

pages = "39--49",

journal = "Acta Endocrinologica, Supplement",

issn = "0804-4635",

publisher = "BioScientifica Ltd.",

number = "1",

}

TY - JOUR

T1 - Risk factors for hyperglycemia in pregnancy in the DALI study differ by period of pregnancy and OGTT time point

AU - Mendoza, Lilian C.

AU - Harreiter, Jürgen

AU - Simmons, David

AU - Desoye, Gernot

AU - Adelantado, J. M.

AU - Juarez, Fabiola

AU - Chico, Ana

AU - Devlieger, Roland

AU - Van Assche, Andre

AU - Galjaard, Sander

AU - Damm, Peter

AU - Mathiesen, Elisabeth R.

AU - Jensen, Dorte M.

AU - Andersen, Lise Lotte T.

AU - Tanvig, Mette

AU - Lapolla, Annunziata

AU - Dalfra, Maria G.

AU - Bertolotto, Alessandra

AU - Mantaj, Urszula

AU - Wender-Ozegowska, Ewa

AU - Zawiejska, Agnieszka

AU - Hill, David

AU - Jelsma, Judith G.

AU - Snoek, Frank J.

AU - Van Poppel, Mireille N.M.

AU - Worda, Christof

AU - Bancher-Todesca, Dagmar

AU - Kautzky-Willer, Alexandra

AU - Dunne, Fidelma P.

AU - Corcoy, Rosa

AU - behalf of the DALI Core Investigator Group

PY - 2018

Y1 - 2018

N2 - Objective: Risk factors are widely used to identify women at risk for gestational diabetes mellitus (GDM) without clear distinction by pregnancy period or oral glucose tolerance test (OGTT) time points. We aimed to assess the clinical risk factors for Hyperglycemia in pregnancy (HiP) differentiating by these two aspects. Design and methods: Nine hundred seventy-one overweight/obese pregnant women, enrolled in the DALI study for preventing GDM. OGTTs were performed at ≤19 + 6, 24–28 and 35–37 weeks (IADPSG/WHO2013 criteria). Women with GDM or overt diabetes at one time point did not proceed to further OGTTs. Potential independent variables included baseline maternal and current pregnancy characteristics. Statistical analysis: Multivariate logistic regression. Results: Clinical characteristics independently associated with GDM/overt diabetes were at ≤19 + 6 weeks, previous abnormal glucose tolerance (odds ratio (OR): 3.11; 95% CI: 1.41–6.85), previous GDM (OR: 2.22; 95% CI: 1.20–4.11), neck circumference (NC) (OR: 1.58; 95% CI: 1.06–2.36 for the upper tertile), resting heart rate (RHR, OR: 1.99; 95% CI: 1.31–3.00 for the upper tertile) and recruitment site; at 24–28 weeks, previous stillbirth (OR: 2.92; 95% CI: 1.18-7.22), RHR (OR: 3.32; 95% CI: 1.70-6.49 for the upper tertile) and recruitment site; at 35–37 weeks, maternal height (OR: 0.41; 95% CI: 0.20–0.87 for upper tertile). Clinical characteristics independently associated with GDM/overt diabetes differed by OGTT time point (e.g. at ≤19 + 6 weeks, NC was associated with abnormal fasting but not postchallenge glucose). Conclusion: In this population, most clinical characteristics associated with GDM/overt diabetes were non-modifiable and differed by pregnancy period and OGTT time point. The identified risk factors can help define the target population for future intervention trials.

AB - Objective: Risk factors are widely used to identify women at risk for gestational diabetes mellitus (GDM) without clear distinction by pregnancy period or oral glucose tolerance test (OGTT) time points. We aimed to assess the clinical risk factors for Hyperglycemia in pregnancy (HiP) differentiating by these two aspects. Design and methods: Nine hundred seventy-one overweight/obese pregnant women, enrolled in the DALI study for preventing GDM. OGTTs were performed at ≤19 + 6, 24–28 and 35–37 weeks (IADPSG/WHO2013 criteria). Women with GDM or overt diabetes at one time point did not proceed to further OGTTs. Potential independent variables included baseline maternal and current pregnancy characteristics. Statistical analysis: Multivariate logistic regression. Results: Clinical characteristics independently associated with GDM/overt diabetes were at ≤19 + 6 weeks, previous abnormal glucose tolerance (odds ratio (OR): 3.11; 95% CI: 1.41–6.85), previous GDM (OR: 2.22; 95% CI: 1.20–4.11), neck circumference (NC) (OR: 1.58; 95% CI: 1.06–2.36 for the upper tertile), resting heart rate (RHR, OR: 1.99; 95% CI: 1.31–3.00 for the upper tertile) and recruitment site; at 24–28 weeks, previous stillbirth (OR: 2.92; 95% CI: 1.18-7.22), RHR (OR: 3.32; 95% CI: 1.70-6.49 for the upper tertile) and recruitment site; at 35–37 weeks, maternal height (OR: 0.41; 95% CI: 0.20–0.87 for upper tertile). Clinical characteristics independently associated with GDM/overt diabetes differed by OGTT time point (e.g. at ≤19 + 6 weeks, NC was associated with abnormal fasting but not postchallenge glucose). Conclusion: In this population, most clinical characteristics associated with GDM/overt diabetes were non-modifiable and differed by pregnancy period and OGTT time point. The identified risk factors can help define the target population for future intervention trials.

U2 - 10.1530/eje-18-0003

DO - 10.1530/eje-18-0003

M3 - Journal article

C2 - 29739812

AN - SCOPUS:85049091105

SN - 0804-4635

VL - 179

SP - 39

EP - 49

JO - Acta Endocrinologica, Supplement

JF - Acta Endocrinologica, Supplement

IS - 1

ER -

Risk factors for hyperglycemia in pregnancy in the DALI study differ by period of pregnancy and OGTT time point

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