nach oben

Archives of Gynecology and Obstetrics

Erschienen in:

02.04.2021 | Maternal-Fetal Medicine

First pregnancy risk factors and future gestational diabetes mellitus

verfasst von: Israel Yoles, Eyal Sheiner, Tamar Wainstock

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 4/2021

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Gestational diabetes mellitus (GDM) affect about 17% of all pregnancies and is associated with significant short- and long-term health consequences for the mother and her offspring. Early diagnosis and prompt interventions may reduce these adverse outcomes. We aimed to identify first pregnancy characteristics as risk factors for GDM in subsequent pregnancy.

Materials and methods

A population-based nested case–control study was conducted in a large tertiary hospital. The study population included all women with two singleton consecutive pregnancies and deliveries, without GDM in the first pregnancy. Characteristics and complications of the first pregnancy were compared among cases and controls. A multivariable logistic regression model was used to study the association between pregnancy complications (in the first pregnancy) and GDM in the subsequent pregnancy, while adjusting for confounding variables.

Results

A total of 38,750 women were included in the study, of them 1.9% (n = 728) had GDM in their second pregnancy. Mothers with GDM in their second pregnancy were more likely to have the following first pregnancy complications: hypertensive disorders, perinatal mortality, maternal obesity and fetal macrosomia. Results remained significant after adjustment for maternal age and inter-pregnancy interval. Having either one of the complications increased the risk for GDM by 2.33 (adjusted OR = 2.33; 95% CI 1.93–2.82) while a combination of two complications increased GDM risk by 5.38 (adjusted OR = 5.38; 95% CI 2.85–10.17).

Conclusions

First pregnancy without GDM complicated by hypertensive disorders, perinatal mortality, maternal obesity and fetal macrosomia was associated with an increased risk for GDM in the subsequent pregnancy. Women with these complications may benefit from early detection of GDM in their subsequent pregnancy.

Guariguata L, Linnenkamp U, Beagley J, Whiting DR, Cho NH (2014) Global estimates of the prevalence of hyperglycaemia in pregnancy. Diabetes Res Clin Pract 103(2):176–185. https://doi.org/10.1016/j.diabres.2013.11.003CrossRefPubMed

Egan AM, Dunne FP (2019) Optimal management of gestational diabetes. Br Med Bull 131(1):97–108. https://doi.org/10.1093/bmb/ldz025CrossRefPubMed

Diabetes in pregnancy: management from preconception to the postnatal period–PubMed–NCBI. https://www.ncbi.nlm.nih.gov/pubmed/32212588. Accessed 5 May 2020.

Zhang C, Rawal S, Chong YS (2016) Risk factors for gestational diabetes: is prevention possible? Diabetologia 59(7):1385–1390. https://doi.org/10.1007/s00125-016-3979-3CrossRefPubMedPubMedCentral

Bottalico JN (2007) Recurrent gestational diabetes: risk factors, diagnosis, management, and implications. Semin Perinatol 31(3):176–184. https://doi.org/10.1053/j.semperi.2007.03.006CrossRefPubMed

Beharier O, Shoham-Vardi I, Pariente G et al (2015) Gestational diabetes mellitus is a significant risk factor for long-term maternal renal disease. J Clin Endocrinol Metab 100(4):1412–1416. https://doi.org/10.1210/jc.2014-4474CrossRefPubMed

Kessous R, Shoham-Vardi I, Pariente G, Sherf M, Sheiner E (2013) An association between gestational diabetes mellitus and long-term maternal cardiovascular morbidity. Heart 99(15):1118–1121. https://doi.org/10.1136/heartjnl-2013-303945CrossRefPubMed

Landon MB, Spong CY, Thom E et al (2009) A multicenter, randomized trial of treatment for mild gestational diabetes. N Engl J Med 361(14):1339–1348. https://doi.org/10.1056/NEJMoa0902430CrossRefPubMedPubMedCentral

Barchilon-Tiosano L, Sheiner E, Wainstock T, Sergienko R, Okby-Cronin R (2019) Long-term risk for maternal cardiovascular morbidities in twin pregnancies complicated with gestational diabetes mellitus–a retrospective cohort study†. J Matern Neonatal Med. https://doi.org/10.1080/14767058.2019.1670805CrossRef

10.

Leybovitz-Haleluya N, Wainstock T, Landau D, Sheiner E (2018) Maternal gestational diabetes mellitus and the risk of subsequent pediatric cardiovascular diseases of the offspring: a population-based cohort study with up to 18 years of follow up. Acta Diabetol 55(10):1037–1042. https://doi.org/10.1007/s00592-018-1176-1CrossRefPubMed

11.

Shorer DT, Wainstock T, Sheiner E, Landau D, Pariente G (2019) Long-term endocrine outcome of small for gestational age infants born to mothers with and without gestational diabetes mellitus. Gynecol Endocrinol 35(11):1003–1009. https://doi.org/10.1080/09513590.2019.1616174CrossRefPubMed

12.

Fuchs O, Sheiner E, Meirovitz M, Davidson E, Sergienko R, Kessous R (2017) The association between a history of gestational diabetes mellitus and future risk for female malignancies. Arch Gynecol Obstet 295(3):731–736. https://doi.org/10.1007/s00404-016-4275-7CrossRefPubMed

13.

Kessous R, Wainstock T, Walfisch A, Sheiner E (2019) The risk for childhood malignancies in the offspring of mothers with previous gestational diabetes mellitus: a population-based cohort study. Eur J Cancer Prev 28(4):377–381. https://doi.org/10.1097/CEJ.0000000000000487CrossRefPubMed

14.

Abokaf H, Shoham-Vardi I, Sergienko R, Landau D, Sheiner E (2018) In utero exposure to gestational diabetes mellitus and long term endocrine morbidity of the offspring. Diabetes Res Clin Pract 144:231–235. https://doi.org/10.1016/j.diabres.2018.09.003CrossRefPubMed

15.

Farahvar S, Walfisch A, Sheiner E (2019) Gestational diabetes risk factors and long-term consequences for both mother and offspring: a literature review. Expert Rev Endocrinol Metab 14(1):63–74. https://doi.org/10.1080/17446651.2018.1476135CrossRefPubMed

16.

Zamstein O, Sheiner E, Wainstock T, Landau D, Walfisch A (2018) Maternal gestational diabetes and long-term respiratory related hospitalizations of the offspring. Diabetes Res Clin Pract 140:200–207. https://doi.org/10.1016/j.diabres.2018.03.050CrossRefPubMed

17.

Beharier O, Sergienko R, Kessous R et al (2017) Gestational diabetes mellitus is a significant risk factor for long-term ophthalmic morbidity. Arch Gynecol Obstet 295(6):1477–1482. https://doi.org/10.1007/s00404-017-4362-4CrossRefPubMed

18.

Gillman MW, Oakey H, Baghurst PA, Volkmer RE, Robinson JS, Crowther CA (2010) Effect of treatment of gestational diabetes mellitus on obesity in the next generation. Diabetes Care 33(5):964–968. https://doi.org/10.2337/dc09-1810CrossRefPubMedPubMedCentral

19.

Baptiste-Roberts K, Nicholson WK, Wang NY, Brancati FL (2012) Gestational diabetes and subsequent growth patterns of offspring: the national collaborative perinatal project. Matern Child Health J 16(1):125–132. https://doi.org/10.1007/s10995-011-0756-2CrossRefPubMedPubMedCentral

20.

Landon MB, Rice MM, Varner MW et al (2015) Mild gestational diabetes mellitus and long-term child health. Diabetes Care 38(3):445–452. https://doi.org/10.2337/dc14-2159CrossRefPubMed

21.

Alptekin H, Çizmecioäÿlu A, Işik H, Cengiz T, Yildiz M, Iyisoy MS (2016) Predicting gestational diabetes mellitus during the first trimester using anthropometric measurements and HOMA-IR. J Endocrinol Invest 39(5):577–583. https://doi.org/10.1007/s40618-015-0427-zCrossRefPubMed

22.

Kansu-Celik H, Ozgu-Erdinc AS, Kisa B, Findik RB, Yilmaz C, Tasci Y (2019) Prediction of gestational diabetes mellitus in the first trimester: comparison of maternal fetuin-A, N-terminal proatrial natriuretic peptide, high-sensitivity C-reactive protein, and fasting glucose levels. Arch Endocrinol Metab 63(2):121–127. https://doi.org/10.20945/2359-3997000000126CrossRefPubMed

23.

Mavreli D, Evangelinakis N, Papantoniou N, Kolialexi A (2020) Quantitative comparative proteomics reveals candidate biomarkers for the early prediction of gestational diabetes mellitus: a preliminary study. In Vivo 34(2):517–525. https://doi.org/10.21873/invivo.11803CrossRefPubMedPubMedCentral

24.

American Diabetes Association (2018) 13. Management of diabetes in pregnancy: standards of medical care in diabetes-2018. Diabetes Care 41(1):S137–S143. https://doi.org/10.2337/dc18-S013CrossRef

25.

Lee J, Ouh YT, Ahn KH et al (2017) Preeclampsia: a risk factor for gestational diabetes mellitus in subsequent pregnancy. PLoS ONE. https://doi.org/10.1371/journal.pone.0178150CrossRefPubMedPubMedCentral

26.

Russell C, Dodds L, Armson BA, Kephart G, Joseph KS (2008) Diabetes mellitus following gestational diabetes: role of subsequent pregnancy. BJOG An Int J Obstet Gynaecol 115(2):253–260. https://doi.org/10.1111/j.1471-0528.2007.01459.xCrossRef

27.

Phipps EA, Thadhani R, Benzing T, Karumanchi SA (2019) Pre-eclampsia: pathogenesis, novel diagnostics and therapies. Nat Rev Nephrol 15(5):275–289. https://doi.org/10.1038/s41581-019-0119-6CrossRefPubMedPubMedCentral

28.

Brownfoot FC, Hastie R, Hannan NJ et al (2016) Metformin as a prevention and treatment for preeclampsia: Effects on soluble fms-like tyrosine kinase 1 and soluble endoglin secretion and endothelial dysfunction. Am J Obstet Gynecol 214(3):356.e1-356.e15. https://doi.org/10.1016/j.ajog.2015.12.019CrossRef

29.

Cluver C, Walker SP, Mol BW et al (2019) A double blind, randomised, placebo-controlled trial to evaluate the efficacy of metformin to treat preterm pre-eclampsia (PI2 Trial): Study protocol. BMJ Open. https://doi.org/10.1136/bmjopen-2018-025809CrossRefPubMedPubMedCentral

30.

Han CS, Herrin MA, Pitruzzello MC et al (2015) Glucose and metformin modulate human first trimester trophoblast function: a model and potential therapy for diabetes-associated uteroplacental insufficiency. Am J Reprod Immunol 73(4):362–371. https://doi.org/10.1111/aji.12339CrossRefPubMed

31.

Romero R, Erez O, Hüttemann M et al (2017) Metformin, the aspirin of the 21st century: its role in gestational diabetes mellitus, prevention of preeclampsia and cancer, and the promotion of longevity. Am J Obstet Gynecol 217(3):282–302. https://doi.org/10.1016/j.ajog.2017.06.003CrossRefPubMedPubMedCentral

32.

Herzig S, Shaw RJ (2018) AMPK: Guardian of metabolism and mitochondrial homeostasis. Nat Rev Mol Cell Biol 19(2):121–135. https://doi.org/10.1038/nrm.2017.95CrossRefPubMed

33.

Carling D (2017) AMPK signalling in health and disease. Curr Opin Cell Biol 45:31–37. https://doi.org/10.1016/j.ceb.2017.01.005CrossRefPubMed

34.

Plaks V, Rinkenberger J, Dai J et al (2013) Matrix metalloproteinase-9 deficiency phenocopies features of preeclampsia and intrauterine growth restriction. Proc Natl Acad Sci USA 110(27):11109–11114. https://doi.org/10.1073/pnas.1309561110CrossRefPubMedPubMedCentral

35.

Waker CA, Albers RE, Pye RL et al (2017) AMPK knockdown in placental Labyrinthine Progenitor cells results in restriction of critical energy resources and terminal differentiation failure. Stem Cells Dev 26(11):808–817. https://doi.org/10.1089/scd.2016.0252CrossRefPubMedPubMedCentral

36.

Carey EAK, Albers RE, Doliboa SR et al (2014) AMPK knockdown in placental trophoblast cells results in altered morphology and function. Stem Cells Dev 23(23):2921–2930. https://doi.org/10.1089/scd.2014.0092CrossRefPubMedPubMedCentral

37.

Kaufman MR, Brown TL (2016) AMPK and Placental Progenitor cells. EXS 107:73–79. https://doi.org/10.1007/978-3-319-43589-3_4CrossRefPubMed

38.

Wu L, Huang XJ, Yang CH et al (2011) 5’-AMP-activated protein kinase (AMPK) regulates progesterone receptor transcriptional activity in breast cancer cells. Biochem Biophys Res Commun 416(1–2):172–177. https://doi.org/10.1016/j.bbrc.2011.11.018CrossRefPubMed

39.

Smith BK, Steinberg GR (2017) AMP-Activated protein kinase, fatty acid metabolism, and insulin sensitivity. Curr Opin Clin Nutr Metab Care 20(4):248–253. https://doi.org/10.1097/MCO.0000000000000380CrossRefPubMed

40.

Jeon S-M (2016) Regulation and function of AMPK in physiology and diseases. Exp Mol Med 48(7):e245. https://doi.org/10.1038/emm.2016.81CrossRefPubMedPubMedCentral

41.

Rena G, Hardie DG, Pearson ER (2017) The mechanisms of action of metformin. Diabetologia 60(9):1577–1585. https://doi.org/10.1007/s00125-017-4342-zCrossRefPubMedPubMedCentral

42.

Foretz M, Guigas B, Bertrand L, Pollak M, Viollet B (2014) Metformin: from mechanisms of action to therapies. Cell Metab 20(6):953–966. https://doi.org/10.1016/j.cmet.2014.09.018CrossRefPubMed

43.

Foretz M, Guigas B, Viollet B (2019) Understanding the glucoregulatory mechanisms of metformin in type 2 diabetes mellitus. Nat Rev Endocrinol 15(10):569–589. https://doi.org/10.1038/s41574-019-0242-2CrossRefPubMed

Titel: First pregnancy risk factors and future gestational diabetes mellitus
verfasst von: Israel Yoles
Eyal Sheiner
Tamar Wainstock
Publikationsdatum: 02.04.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Gynecology and Obstetrics / Ausgabe 4/2021
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-021-06024-8

Neu im Fachgebiet Gynäkologie und Geburtshilfe

Mammakarzinom: Brustdichte beeinflusst rezidivfreies Überleben

26.05.2024 Mammakarzinom Nachrichten

Frauen, die zum Zeitpunkt der Brustkrebsdiagnose eine hohe mammografische Brustdichte aufweisen, haben ein erhöhtes Risiko für ein baldiges Rezidiv, legen neue Daten nahe.

Mehr Lebenszeit mit Abemaciclib bei fortgeschrittenem Brustkrebs?

24.05.2024 Mammakarzinom Nachrichten

In der MONARCHE-3-Studie lebten Frauen mit fortgeschrittenem Hormonrezeptor-positivem, HER2-negativem Brustkrebs länger, wenn sie zusätzlich zu einem nicht steroidalen Aromatasehemmer mit Abemaciclib behandelt wurden; allerdings verfehlte der numerische Zugewinn die statistische Signifikanz.

Blutdrucksenkung könnte Uterusmyome verhindern

21.05.2024 Krebsvorsorge in der Gynäkologie Nachrichten

Frauen mit unbehandelter oder neu auftretender Hypertonie haben ein deutlich erhöhtes Risiko für Uterusmyome. Eine Therapie mit Antihypertensiva geht hingegen mit einer verringerten Inzidenz der gutartigen Tumoren einher.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

First pregnancy risk factors and future gestational diabetes mellitus

Abstract

Purpose

Materials and methods

Results

Conclusions

Neu im Fachgebiet Gynäkologie und Geburtshilfe

Mammakarzinom: Brustdichte beeinflusst rezidivfreies Überleben

Mehr Lebenszeit mit Abemaciclib bei fortgeschrittenem Brustkrebs?

Blutdrucksenkung könnte Uterusmyome verhindern

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

Update Gynäkologie

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Abstract

Purpose

Materials and methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 4/2021

Notch signaling pathway in cumulus cells reflecting zygote and embryo quality in polycystic ovary syndrome

Cardiovascular disease and cancer in women with accreta and retained placenta: a longitudinal cohort study

Cleavage vs blastocyst stage embryos: how are they interrelating?

Pregnancy outcomes of infertile women with ultrasound-diagnosed adenomyosis for in vitro fertilization and frozen–thawed embryo transfer

Evaluation of the sexual quality of life and sexual function of cervical cancer survivors after cancer treatment: a retrospective trial

Guided tour of hidden tracts in the pelvis: exploring pelvic fistulas

Neu im Fachgebiet Gynäkologie und Geburtshilfe

Mammakarzinom: Brustdichte beeinflusst rezidivfreies Überleben

Mehr Lebenszeit mit Abemaciclib bei fortgeschrittenem Brustkrebs?

Blutdrucksenkung könnte Uterusmyome verhindern

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

Update Gynäkologie