Monitoring can predict gestational diabetes well before pregnancy

Monitoring known risk factors for diabetes and heart disease can identify women at high risk of developing gestational diabetes mellitus (GDM) as much as 7 years before they become pregnant, researchers from Oakland, California, report.

Their case-control study, published online May 30 in the American Journal of Obstetrics and Gynecology, compared 199 women with GDM with 381 controls selected from a multiethnic cohort of women in the Kaiser Permanente Northern California health system. All had undergone multiphasic health checkups to screen for conditions such as heart disease, diabetes, and cancer between 1984 and 1996 and subsequently became pregnant. They were matched by year and age at multiphasic examination and age at delivery.

The risk of GDM rose with the number of prepregnancy risk factors linked to diabetes and heart disease, including overweight or obesity, hyperglycemia, prehypertension or hypertension, and hypercholesterolemia.

“In this study, pregravid cardiometabolic risk factors that were assessed on average 7 years before pregnancy were associated with an increased risk of subsequent GDM,” the authors write. These risk factors “may help to identify women who are at high risk of GDM to target for prevention strategies,” they conclude.

The researchers note that “pregravid overweight/obesity and mild hyperglycemia were associated strongly and independently with an increased risk of GDM.” Women with elevated body mass index and blood glucose had a 4.6-fold greater risk of GDM than women with normal body mass and glucose levels (P=.0001).

Measures aimed to reduce GDM have “enormous potential” in light of studies demonstrating that lifestyle interventions significantly lower the risk of developing type 2 diabetes among high-risk populations, the researchers say.