Maternal antenatal body mass index BMI and degree of glucose intolerance in pregnancies affected by gestational diabetes mellitus

Introduction: Gestational diabetes mellitus (GDM) is a condition of transient glucose intolerance presenting in pregnancy. GDM has increased in prevalence worldwide and is a growing public health concern due to its... [ view full abstract ]

Introduction: Gestational diabetes mellitus (GDM) is a condition of transient glucose intolerance presenting in pregnancy. GDM has increased in prevalence worldwide and is a growing public health concern due to its consequences for mother and infant during and after pregnancy. Diagnostic criteria are currently based on excursions from the norms of thresholds set out around a 75g oral glucose tolerance test (OGTT) procedure according to International Association of the Diabetes and Pregnancy Study Groups (IADPSG) guidelines, at 28 weeks gestation. Data from this retrospective cohort study aims to present the degree of glucose intolerance in pregnancies affected by GDM. 

Methods: Data were abstracted from patient medical records. Records of singleton pregnancies affected by GDM born in 2016 at the University Maternity Hospital Limerick (UMHL) who were not treated with insulin were included. Data was recorded during routine hospital visits by medics and allied health professionals. Demographic data was acquired by facilitated questionnaires; anthropometrics measured at the first antenatal appointment; and blood biochemistry through laboratory diagnostic tests. Post risk stratification, patients undergo a 75g OGTT as a diagnostic test for. Plasma glucose area under the curve (PG-AUC) was calculated from OGTT results as an index of glucose intolerance.

Results: 216 pregnant women aged between 18.2-44.0 years, diagnosed with GDM were described. Maternal antenatal BMI (15.9-48.2 kg.m^-2) and OGTT results from 28 weeks gestation are presented. PG-AUC did not correlate with maternal BMI (PG-AUC 23.9 ± 3.8 mmol.h/L, BMI 28.3±6.2 kg.m^-2, r_s(207)=-0.029, p=0.358).

Conclusion: Body mass index (BMI) is used as one of the risk stratifications for identifying those patients with greater risk of developing GDM. However, insight into the body composition of pregnant women can potentially be of diagnostic importance in detecting GDM at an earlier stage in gestation.