Reported prevalence of gestational diabetes in Scotland: the relationship with obesity, age, socioeconomic status, smoking and macrosomia, and how many are we missing?

Aims/Introduction: Gestational diabetes mellitus (GDM) is defined as ‘carbohydrate intolerance of varying degrees of severity with onset or first recognition during pregnancy,’ and is associated with increased fetal and maternal risks. The aims of the present study were to investigate the prevalence of GDM in Scotland over 32 years (1981–2012), and using the data from 2012, to assess how GDM related to maternal body mass index, maternal age, parity, smoking, Scottish Index of Multiple Deprivation, infant gender and macrosomia status. Materials and Methods: GDM prevalence along with anthropometric, obstetric and demographic data were collected on a total of 1,891,097 women with a delivery episode between 1 January 1981 and 31 December 2012 using data extracted from the Scottish Morbidity Record 02. Univariate and multivariate logistic regression analysis was undertaken to investigate their association with GDM. Results: A ninefold increase in GDM prevalence was observed from 1981 to 2012 (P < 0.001). GDM prevalence in 2012 was 1.9%. Maternal body mass index, age, parity status, Scottish index of multiple deprivation and fetal macrosomia were positively associated with GDM. Reported smoking status at booking was inversely associated with GDM. Multivariable analysis showed that fetal macrosomia was not associated with GDM status. Conclusions: The present study confirmed that the reporting of GDM is low in Scotland, and that GDM is associated with maternal body mass index, maternal age, multiparity and social deprivation. GDM was negatively associated with smoking and requires further investigation. The lack of association between GDM and macrosomia (following multivariate analysis) might reflect the screening processes undertaken in Scotland

Gestational Diabetes Mellitus and Obesity

This is the sixth of a series of articles based on presentations at the America

The Association Between Maternal Glucose Concentration and Child BMI at Age 3 Years

OBJECTIVE—The objective of the study was to determine the association between child BMI at age 3 years and maternal glucose concentration among women without pre-existing diabetes or a gestational diabetes mellitus (GDM) diagnosis. RESEARCH DESIGN AND METHODS—Data are from the Pregnancy Infection and Nutrition and Postpartum studies and include 263 mother-child pairs. Measured weights and heights at 3 years were used to calculate age- and sex-specific BMIz scores and percentiles. Multivariable linear regression models were used to examine associations of continuous BMI z scores with maternal glucose concentration. Modified Poisson regression estimated risk ratios of child overweight/obesity (BMI $85th percentile). RESULTS—The mean (SD) maternal glucose concentration and prepregnancy BMI were 103.8 (23.7) mg/dL and 24.3 (5.9) kg/m 2, respectively. At 3 years, the mean (SD) child BMI z score was 0.29 (0.99), 20.9$130 mg/dL was associated with significantly higher child BMI z score at 3 years (estimated z scoredifferenceof0.39[95

ATLANTIC DIP: The Impact of Obesity on Pregnancy Outcome in Glucose-Tolerant Women

OBJECTIVE - A prospective Study of the impact of obesity on pregnancy Outcome in glucose-tolerant women. RESEARCH DESIGN AND METHODS - The Irish Atlantic Diabetes in Pregnancy network advocates universal screening for gestational diabetes. Women with normoglycemia and a recorded booking BMI were included. Maternal and infant outcomes correlated with booking BMI are reported. RESULTS - A total of 2,329 women fulfilled the criteria. Caesarean deliveries increased in overweight (OW) (odds ratio 1.57 [95% Cl 1.24-1.98]) and obese (013) (2.65 [2.03-3.46]) women. Hypertensive disorders increased in OW (2.30 11.55-3.40]) and 013 (3.29 [2.14-5.05]) women. Reported miscarriages increased in 013 (1,4 [1.11-1.77]) women. Mean birth weight was 3.46 kg in normal BMI (NBMI), 3.54 kg in OW, and 3.62 kg in 013 (P < 0.01) Mothers. Macrosomia occurred in 15.5, 21.4, and 27.8% of babies of NBMI, OW, and 013 mothers, respectively (P < 0.01). Shoulder dystocia occur in 4% (>4 kg) compared with 0.2% (<4 kg) babies (P < 0.01). Congenital malformation risk increased for 013 (2.47 [1.09-5.60]) women. CONCLUSIONS - OW and OB glucose-tolerant women have greater adverse pregnancy outcomes

Estimates of Insulin Sensitivity Using Glucose and C-Peptide From the Hyperglycemia and Adverse Pregnancy Outcome Glucose Tolerance Test

OBJECTIVE - To determine if glucose and C-peptide values obtained as part of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study could be used to estimate insulin sensitivity during late pregnancy