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Early predictors of gestational diabetes mellitus in IVF-conceived pregnancies
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Coussa, Ayla, Hayder, H. A. and Barber, Thomas M. (2021) Early predictors of gestational diabetes mellitus in IVF-conceived pregnancies. Endocrine Practice, 27 (6). pp. 579-585. doi:10.1016/j.eprac.2020.10.020 ISSN 1530-891X.
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Official URL: https://doi.org/10.1016/j.eprac.2020.10.020
Abstract
Objective
Gestational diabetes mellitus (GDM) associates with adverse maternal and foetal outcomes. The aim of our study was to identify early and reliable GDM predictors, which will enable implementation of preventive and management measures.
Methodology
28-week prospective cohort of IVF-conceived pregnant women (≤39years, BMI 18.5-38kg/m2) without known history of diabetes mellitus. Fasting blood samples were analysed at baseline (pre-IVF) and 12-week gestation for reproductive hormones, glucose, serum insulin, lipids, thyroid function, adiponectin and LBP. At 28 weeks, 75-gram OGTT was used to screen for GDM.
Results
For the pregnant group overall at baseline, 22% had a BMI≥30kg/m2, 45% with PCOS, 16% with HbA1c of 5.7–6.1% and 14% with a past history of GDM. At 28-week gestation (n=158): 34 women developed GDM and 124 did not. Significant baseline predictors of GDM onset included: greater BMI (29.0 vs. 25.8kg/m2), older age (34 vs. 32years) and higher levels of FSH/LH ratio (1.2 vs. 1.0), HbA1C (5.5 vs. 5.2%), insulin (10.6 vs. 7.1μIU/mL), HOMA-IR (2.2 vs. 1.7), T-Chol (199 vs. 171mg/dL) and LDL-C (123 vs. 105mg/dL), and lower TG levels (74 vs. 76mg/dL). Significant 12-week GDM predictors included: greater maternal weight gain (delta: 3.4 vs. 1.5kg) and higher levels of insulin (11.3 vs. 7.6μIU/mL), TG (178 vs. 120mg/dL) and HOMA-IR (2.3 vs. 1.5). 12-week BMI is a predictor of GDM following adjustment for PCOS status and maternal age.
Conclusion
While preconception maternal BMI, age and FSH/LH ratio are predictors for subsequent development of GDM, early IVF-conceived gestational weight gain predicted best GDM onset.
Item Type: | Journal Article | ||||||||
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Subjects: | R Medicine > RC Internal medicine | ||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine > Metabolic and Vascular Health (- until July 2016) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | Endocrine Practice | ||||||||
Publisher: | American Association of Clinical Endocrinologists | ||||||||
ISSN: | 1530-891X | ||||||||
Official Date: | June 2021 | ||||||||
Dates: |
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Volume: | 27 | ||||||||
Number: | 6 | ||||||||
Page Range: | pp. 579-585 | ||||||||
DOI: | 10.1016/j.eprac.2020.10.020 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Reuse Statement (publisher, data, author rights): | © 2021 Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ | ||||||||
Access rights to Published version: | Restricted or Subscription Access | ||||||||
Copyright Holders: | © 2020 Published by Elsevier Inc. on behalf of the American Association of Clinical Endocrinologists. | ||||||||
Date of first compliant deposit: | 2 November 2020 | ||||||||
Date of first compliant Open Access: | 28 December 2021 | ||||||||
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