Age at Menarche, Menstrual Characteristics, and Risk of Preeclampsia

We examined associations of age at menarche and menstrual characteristics with the risk of preeclampsia among participants (n = 3,365) of a pregnancy cohort study. Data were collected using in-person interviews and medical record abstraction. Logistic regression was used to estimate adjusted odds ratio (OR) and 95% confidence interval (95% CI). There was a significant inverse association between age at menarche and risk of preeclampsia (P value for trend < 0.05). Association of long cycle length (>36 days) with higher risk of preeclampsia was present only among women who had prepregnancy body mass index <25 kg/m2 (interaction P value = 0.04). Early menarche is associated with higher risk of preeclampsia. Prepregnancy weight may modify associations of long menstrual cycles with risk of preeclampsia

Glucose intolerance and gestational diabetes risk in relation to sleep duration and snoring during pregnancy: a pilot study

<p>Abstract</p> <p>Background</p> <p>Insufficient sleep and poor sleep quality, considered endemic in modern society, are associated with obesity, impaired glucose tolerance and diabetes. Little, however, is known about the consequences of insufficient sleep and poor sleep quality during pregnancy on glucose tolerance and gestational diabetes.</p> <p>Methods</p> <p>A cohort of 1,290 women was interviewed during early pregnancy. We collected information about sleep duration and snoring during early pregnancy. Results from screening and diagnostic testing for gestational diabetes mellitus (GDM) were abstracted from medical records. Generalized linear models were fitted to derive relative risk (RR) and 95% confidence intervals (95% CIs) of GDM associated with sleep duration and snoring, respectively.</p> <p>Results</p> <p>After adjusting for maternal age and race/ethnicity, GDM risk was increased among women sleeping ≤ 4 hours compared with those sleeping 9 hours per night (RR = 5.56; 95% CI 1.31-23.69). The corresponding RR for lean women (<25 kg/m²) was 3.23 (95% CI 0.34-30.41) and 9.83 (95% CI 1.12-86.32) for overweight women (≥ 25 kg/m²). Overall, snoring was associated with a 1.86-fold increased risk of GDM (RR = 1.86; 95% CI 0.88-3.94). The risk of GDM was particularly elevated among overweight women who snored. Compared with lean women who did not snore, those who were overweight and snored had a 6.9-fold increased risk of GDM (95% CI 2.87-16.6).</p> <p>Conclusions</p> <p>These preliminary findings suggest associations of short sleep duration and snoring with glucose intolerance and GDM. Though consistent with studies of men and non-pregnant women, larger studies that include objective measures of sleep duration, quality and apnea are needed to obtain more precise estimates of observed associations.</p

Early Pregnancy Maternal Hepatocyte Growth Factor and Risk of Gestational Diabetes

Aims We investigated associations of serum hepatocyte growth factor (HGF) with risk of gestational diabetes mellitus (GDM). We also examined whether pre-pregnancy overweight/obesity status or leisure-time physical activity (LTPA) modify these associations. Methods: In a nested case-control study (173 GDM cases and 187 controls) among participants of a pregnancy cohort, early pregnancy (16 weeks of gestation, on average) serum HGF was measured using enzyme-linked immunoassay. GDM was diagnosed using American Diabetes Association guidelines. Logistic regression was used to calculate odd ratios (ORs) and 95% confidence intervals (CI). Effect modifications by pre-pregnancy overweight/obesity status or LTPA during pregnancy were examined using stratified analyses and interaction terms. Results: Overall, we did not find significant associations of serum HGF with GDM risk (p-value> 0.05). However, compared with women who had low serum HGF concentrations (<2.29 ng/ml), women with high serum HGF concentrations (≥ 2.29 ng/ml) had 3.8-fold (95%CI: 1.30–10.98) and 4.5-fold (95%CI: 1.28–15.80) higher GDM risk among women who were overweight/obese, pre-pregnancy (body mass index≥25 kg/m2), or did not report LTPA, respectively. These associations were not present among women who were not overweight/obese (interaction p=0.05) or reported LTPA (interaction p=0.05). Conclusion: Overweight/obesity status and LTPA may modify associations of early pregnancy serum HGF with subsequent GDM risk

Early second trimester retinol-binding protein-4 values in cases with or without gestational diabetes mellitus risk factors: A cross-sectional study

Aim: Retinol-binding protein-4 (RBP-4) has been correlated with different degrees of insulin resistance includinggestational diabetes mellitus (GDM). Presence of risk factors for GDM is an indication for early screening.We studied RBP-4 values in the early second trimester of pregnancy in pregnant subjects with or without GDMrisk factors and compared the results by routine GDM screening methodology.Methods: Seventy-nine patients with at least one GDM risk factor and 46 patients without any GDM riskfactors were enrolled in the cross-sectional study as risk and control groups, respectively. In the early secondtrimester, RBP-4 values were measured, in addition to fasting plasma glucose and 50-g glucose challenge testin all subjects.Results: The RBP-4 values in 16–18th weeks of pregnancy were not significantly different between risk andcontrol groups (95.3 ± 20.1 vs 103.1 ± 24.4 µg/mL, respectively; P = 0.055) although fasting plasma glucoselevels and 50-g glucose challenge test results were higher in the risk group than the control group (75.3 vs69.3 mg/dL and 112.4 vs 97.5 mg/dL, respectively; P < 0.05).Conclusion: Presence of GDM risk factors does not have an impact on early second trimester RBP-4 values inpregnant subjects