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A case–control study to predict the risk of gestational diabetes mellitus by initial fasting blood sugar or past gestational history
Ezazi Bojnordi, Tahmineh; Hantoushzadeh, Sedigheh; Sabzevary, Masomeh & Heidari, Zahra
Abstract
Background: Gestational diabetes mellitus (GDM) deserves proper prevention,
diagnosis, and management due to healthcare implications from both maternal and
fetal concerns.
Objective: To evaluate the rate and investigate the risk factors for developing GDM.
Materials and Methods: In this case-control, universal screening for GDM between 24
and 28 wk of gestation was performed in 613 pregnant women attending a prenatal
clinic in Tehran who were followed-up until delivery between March 2017 to March
2018. Of the 613 women, 143 had GDM and 470 had normal glucose tolerance test as
the primary diagnosis. Some GDM risk factors were compared in two groups.
Results: Impaired glucose tolerance test was detected in 143 (23.3%) patients.
Prevalence of GDM was higher in the first-trimester fasting blood sugar (FBS) > 90
qmg/dl group (p < 0.001). Comparison of the GDM and the normal glucose tolerance
test groups demonstrated significant differences in maternal age, first-trimester FBS,
third-trimester vitamin D level, maternal platelet count, maternal body mass index
(BMI) (before 12 wk of gestation), weight gain during pregnancy, and the history of
gestational complications in previous pregnancy (p < 0.01). In logistic regression, GDM
was independently associated with older maternal age, higher first-trimester FBS,
the history of gestational complications in previous pregnancy, lower third-trimester
vitamin D level, and higher maternal platelet count (p < 0.01).
Conclusion: Both patients with higher initial FBS and the history of gestational
complications in previous pregnancy should be considered high risk for GDM and
screened earlier.
Keywords
Diabetes Mellitus; Gestational; Blood glucose; Risk factor.
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