The risk of developing diabetes in pregnancy can be predicted up to seven years before by carefully monitoring known risk factors associated with diabetes and heart risk said researchers in California whose findings are published online today in the American Journal of Obstetrics and Gynecology.
Research shows that developing diabetes in pregnancy, a type known as gestational diabetes mellitus (GDM), makes a woman more likely to develop Type 2 diabetes afterwards.
GDM is characterized by glucose intolerance that typically starts around the second or third trimester. In the United States, GDM leads to complications for about 7% of women who carry to full term; it can lead to early delivery and Cesarean sections, and it can also increase the baby’s risk for diabetes, obesity and metabolic disorders later in life.
For the study, researchers at health care provider Kaiser Permanente’s Division of Research in Oakland, California, looked at the healthcare records of 580 ethnically diverse female plan members in Northern California who had undergone multiphasic health checkups between 1984 and 1996 and who became pregnant after that.
Multiphasic health checkups are a series of procedures and tests given to thousands of Kaiser Permanente members to screen for conditions such as heart disease, diabetes, and cancer.
The researchers compared the women who developed GDM during pregnancy (199) to women who did not (381), matching them by year and age at multiphasic health checkup examination and age at delivery.
They found that the risk of developing GDM went up in line with the number of risk factors known to be linked with diabetes and heart disease, such as being overweight, having high blood sugar, high blood pressure, and adverse cholesterol levels before pregnancy.
They noted that:
“Adverse levels of both body mass index and glucose were associated with a 4.6-fold increased risk of GDM, compared with women with normal levels (P = .0001)”.
Lead author and research scientist at Kaiser, Dr Monique Hedderson, told the press that:
“Our study indicates that a woman’s cardio-metabolic risk profile for factors routinely assessed at medical visits such as blood sugar, high blood pressure, cholesterol and body weight can help clinicians identify high-risk women to target for primary prevention or early management of GDM.”
The researchers believe this is the first study to examine such routine measures in women before pregnancy who later become pregnanct and develop GDM.
Although the established risk factors for GDM are having a family history of diabetes, being older, obese, non-white, and having previously given birth to a very large baby, about half the women who actually develop GDM don’t have them.
This study helps to understand how else we might be able to predict GDM before pregnancy so women at higher risk can be offered programs to reduce them, say the researchers.
They add that their findings support the idea that women should receive pre-conception care to ensure they remain healthy through their pregnancy, as recommended in a 2006 report from the US Centers for Disease Control and Prevention.
“Pregravid cardiometabolic risk profile and risk for gestational diabetes mellitus.
Monique M. Hedderson, Jeanne A. Darbinian, Charles P. Quesenberry, and Assiamira Ferrara.
Am J Obstet Gynecol, Published online 30 May 2011.
DOI:10.1016/j.ajog.2011.03.037
Additional source: Kaiser Permanente.
Written by: Catharine Paddock, PhD