Maternal glycemia of first trimester of pregnancy and probability of suffering gestational diabetes. Categorization according to pregestational body mass index
DOI:
https://doi.org/10.47196/diab.v55i3.479Keywords:
gestational diabetes, pregnancy, first trimester fasting blood glucose, macrosomiaAbstract
Gestational diabetes (GD) is a metabolic disorder characterized by maternal hyperglycemia that generates short-term and long-term maternal-fetal complications, both for the mother and the child. Early detection is essential to avoid these complications, being its diagnosis simple and accessible to the general population. The pregnant woman normally has fasting blood glucose levels lower than 85 mg / dl during the first trimester, so values above this level in this period of pregnancy are one of the risk factors associated with the development of GD. Lifestyle changes are essential to prevent this disease. Alertness among OB / GYN physicians is essential to carry out generalized screening of all pregnant women in weeks 24-28 or before this date if suspicion is high. The increasing increase in overweight and obesity in women of childbearing age together with excessive weight gain throughout pregnancy are risk factors for the development of this pathology. From the first trimester, it can be observed how these risk factors generate increases in the average of fasting blood glucose values. Furthermore, in these patients a greater predisposition to maternal hypertriglyceridemia is detected during the third trimester, which favors fetal macrosomia.
References
I. The HAPO Study Cooperative Research Group. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med 2008; 358:1991-2002.
II. Salzberg S, et al. Guías de diagnóstico y tratamiento de diabetes gestacional. ALAD, 2016. Recomendaciones. Revista de la Sociedad Argentina de Diabetes dic 2016; Vol. 50, Nº 3:117-128.
III. Seabra G, Saunders C, de Carvalho Padilha P, et al. Association between maternal glucose levels during pregnancy and gestational diabetes mellitus: an analytical cross-sectional study. Diabetol Metab Syndr 2015; 7, 17. DOI: 10.1186/s13098-015-0013-8.
IV. Koivusalo SB, Rönö K, Klemetti MM, et al. Gestational diabetes mellitus can be prevented by lifestyle intervention: the Finnish gestational diabetes prevention study (RADIEL): a randomized controlled trial. Diabetes Care 2016; 39:24-30. DOI: 10.2337/dc15-0511
V. Brown J, Alwan NA, West J, Brown S, McKinlay CJ, Farrar D, et al. Lifestyle interventions for the treatment of women with gestational diabetes. Cochrane Database Syst Rev 2017; 5:CD011970. DOI:10.1002/14651858.CD011970.pub2.
VI. Etchegoyen GS, de Martini ER, Parral-Longobardi C, Cédola N, Alvariñas J, González C, et al. Diabetes gestacional: determinación del peso relativo de sus factores de riesgo. Medicina (Buenos Aires) 2011; 61:161-66.
VII. Chen H, Cohen P, Chen S. How big is a big odds ratio? Interpreting the magnitudes of odds ratios in epidemiological studies. Commun Stat Simul Comput 2010; 39:860-864.
VIII. Sesmilo G, Prats P, Garcia S, et al. First-trimester fasting glycemia as a predictor of gestational diabetes (GDM) and adverse pregnancy outcomes. Acta Diabetol 2020; 57 (6):697-703. DOI: 10.1007/s00592-019-01474-8.
IX. Dipietro L, Evenson KR, Bloodgood B, Sprow K, Troiano RP, Piercy KL, et al. Physical Activity Guidelines Advisory Committee. Benefits of physical activity during pregnancy and postpartum: an umbrella review. Med Sci Sports Exerc 2019; 51:1292-1302.
X. Phelan S. Pregnancy: a “teachable moment” for weight control and obesity prevention. Am J Obstet Gynecol 2010; 202:e131-e138.
XI. Ehremberg HM, Mercer BM, Catalamo PM. The influence of obesity and diabetes on the prevalence of macrosomia. Am J Obstet Gynecol 2004; 191:964- 8.
XII. Ricart W, López J, Mozas J, Pericot A, Sancho MA, González N, et al. Body mass index has a greater impact on pregnancy outcomes than gestational hyperglycaemia. Diabetologia 2005; 48:1736-42.
XIII. Owens LA, O’Sullivan EP, Kirwan B, Ávalos G, Gaffney G, Dunne F; ATLANTIC DIP collaborators. ATLANTIC DIP: the impact of obesity on pregnancy outcome in glucose-tolerant women. Diabetes Care 2010; 33(3):5779.
XIV. Pinheiro RL, Areia AL, Mota Pinto A, Donato H. Advanced maternal age: adverse outcomes of pregnancy, a meta-analysis. Acta Med Port 2019; 32:219- 26.
XV. Riskin-Mashiah S, Younes G, et al. First-trimester fasting hyperglycemia and adverse pregnancy outcomes. Diabetes Care 2009 Sep; 32(9):1639-1643. DOI: 10.2337/dc09-0688.
XVI. Cuarta Encuesta Nacional de Factores de Riesgo. Resultados
preliminares. 1º Ed. Ciudad Autónoma de Buenos Aires: Instituto Nacional de Estadísticas y Censos (INDEC), Secretaría de Gobierno de Salud 2019. ISBN 978-950-896- 542-4. Disponible en:https://www.indec.gob.ar/ftp/cuadros/publicaciones/enfr_2018_resultados_definitivos.pdf.
XVII. Falcone V, Kotzaeridi G, Breil MH, et al. Early assessment of the risk for gestational diabetes mellitus: can fasting parameters of glucose metabolism contribute to risk prediction? Diabetes Metab J 2019; 43(6):785-793. DOI: 10.4093/dmj.2018.0218.
XVIII. López del Val T, Alcázar-Lázaro V, García-Lacalle C, et al. Glucemia basal en el primer trimestre como acercamiento inicial al diagnóstico de la diabetes en el embarazo. Endocrinol Diabetes Nutr 2019; 66:11-18. DOI: 10.1016/j.endinu.2018.06.012.
XIX. Sacks DA, Chen W, Wolde-Tsadik G, Buchanan TA. Fasting plasma glucose test at the frst prenatal visit as a screen for gestational diabetes. Obstet Gynecol 2003; 101:1197-1203. DOI: 10.1016/s0029-7844(03)00049-8.
XX. Ryckman KK, Spracklen CN, Smith CJ, Robinson JG, Saftlas AF. Maternal lipid levels during pregnancy and gestational diabetes: a systematic review and meta-analysis. BJOG 2015; 122:643-651.
XXI. Hashemipour S, et al. Level of maternal triglycerides is a predictor of fetal macrosomia in non-obese pregnant women with gestational diabetes mellitus. Pediatr Neonatol 2018; 59(6):567-572. DOI: 10.1016/j.pedneo.2018.01.008.
XXII. Mitanchez D, Burguet A, Simeoni U. Infants born to mothers with gestational diabetes mellitus: mild neonatal effects, a long-term threat to global health. J Pediatr 2014; 164: 445-450.
XXIII. Harder T, Rodekamp E, Schellong K, Dudenhausen JW, Plagemann A. Birth weight and subsequent risk of type 2 diabetes: a meta analysis. Am J Epidemiol 2007; 165:849-857.
XXIV. Sameshima H, Kamitomo M, Kajiya S, Kai M, Furukawa S, Ikenoue S. Early glycemic control reduces large-for-gestational-age infants in 250 Japanese gestational diabetes pregnancies. Am J Perinatol 2000; 17:371-376.
XXV. Son GH, Kwon JY, Kim YH, Park YW. Maternal serum triglycerides as predictive factors for large-for-gestational age newborns in women with gestational diabetes mellitus. Acta Obstet Gynecol Scand 2010; 89:700-704.
XXVI. Olmos PR, Rigotti A, Busso D, Berkowitz L, Santos JL, Borzone GR, et al. Maternal hypertriglyceridemia: a link between maternal overweight-obesity and macrosomia in gestational diabetes. Obesity (Silver Spring) 2014; 22:2156-2163.
XXVII. Chen Q, Wei J, Tong M, Yu L, Lee AC, Gao YF, et al. Associations between body mass index and maternal weight gain on the delivery of LGA infants in Chinese women with gestational diabetes mellitus. J Diabetes Complications 2015; 29:1037-1041.
XXVIII. Gorbán de Lapertosa S, Alvariñas J, Elgart JF, Salzberg S, Gagliardino JJ; on behalf of the EduGest group. The triad macrosomia, obesity, and hypertriglyceridemia in gestational diabetes. Diabetes Metab Res Rev 2020; 36(5):e03302. DOI: 10.1002/dmrr.3302.
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