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Metabolic Status Before Pregnancy Predicts Subsequent Gestational Diabetes
Date:10/12/2010

n and behavioral treatment options are more limited during pregnancy, the time to prevent gestational diabetes is before pregnancy begins," said study lead investigator Erica P. Gunderson, PhD, an epidemiologist and research scientist at the Kaiser Permanente Division of Research in Oakland, Calif. "Screening and treatment of metabolic risk factors before pregnancy to prevent GDM may help reduce its lasting adverse health effects on children, by possibly improving the uterine environment," she added.

Researchers studied 1,164 women without diabetes before pregnancy who delivered 1,809 live births during the course of five consecutive exams from 1985-2006 as part of a Coronary Artery Risk Development in Young Adults study. Participant characteristics – including  lifestyle, socio-demographic, medical conditions, medication use, family history of diabetes, pregnancies and births and GDM status, as well as clinical assessments, body measurements and blood specimens – were  obtained at baseline. Follow-up exams used standardized research methodologies, including self- and interviewer-administered questionnaires.

Impaired fasting glucose, elevated fasting insulin and low HDL-cholesterol before pregnancy were associated with higher risk of GDM. Of the 1,809 live births studied, 154 (8.5 percent) involved a GDM pregnancy.

Among overweight women, 26.7 percent with one or more cardio-metabolic risk factors before pregnancy developed gestational diabetes versus 7.4 percent who did not have cardio-metabolic risk factors.

Although obesity and belly fat are antecedents to insulin resistance, pre-pregnancy obesity was not independently predictive of GDM after taking into account cardio-metabolic risk factors. Researchers also found no association between pre-pregnancy blood pressure or hypertension and risk of GDM, possibly due to the low prevalence of these conditions in healthy women of reproductive age.

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SOURCE Kaiser Permanente
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