Clinical Risk Factors and First Gestational 75 g OGTT May Predict Recurrent and New-Onset Gestational Diabetes in Multiparous Women
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Statistical Analysis
3. Results
3.1. Exploring Risk Factors for GDM through Retrospective Digital Health Data Collection
3.2. Correlations between First and Second Gestational 75 g OGTTs
3.3. Regression and Receiving Operating Characteristic (ROC) Analysis to Test the Predictive Effects of First Gestational 75 g OGTT Post-Load Glucose Values
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Clinical and 75 g OGTT Characteristics of Women | NGT at Index (or First) Pregnancy | GDM at Index (or First) Pregnancy | ||
---|---|---|---|---|
Group 1 (n = 493) NGT at Subsequent Pregnancy | Group 2 (n = 74) GDM in Subsequent Pregnancy | Group 3 (n = 92) Non-Recurrent GDM | Group 4 (n = 100) Recurrent GDM | |
Ethnicity | Caucasian | Caucasian | Caucasian | Caucasian |
Secondary or tertiary level education (n) | 433 (87.8%) | 64 (86.4%) | 84 (91.3%) | 84 (84.0%) |
Smoker or ex-smoker (n) | 64 (13.0%) | 10 (13.5%) | 9 (9.8%) | 8 (8%) |
Familial history of T2D (n) | 250 (50.7%) | 50 (67.6%) | 67 (72.9%) § | 68 (68.0%) |
Age at menarche (y) | 12 (11–13) | 12 (11–13) | 12 (11–13) | 12 (11–12) ‡• |
PCOS (n) | 8 (1.6%) | 2 (2.7%) | 10 (10.9%) § | 34 (34.0%) ‡¤• |
Nullipara women at index pregnancy (n) | 304 (61.7%) | 48 (64.9%) | 65 (70.7%) | 69 (69.0%) |
Reproductive history of spontaneous abortion (n) | 100 (20.3%) | 10 (13.5%) | 16 (17.4%) | 16 (16.0%) |
Pregravid body weight index pregnancy (kg) | 59.0 (53.0–67.0) | 61.5 (55.0–68.0) | 61.0 (55.8–70.0) | 68.0 (57.8–78.0) ‡¤• |
Pregravid BMI index pregnancy (kg/m2) | 22.3 (20.4–25.0) | 23.4 (20.9–25.5) | 22.8 (20.9–25.8) | 26.0 (22.2–29.1) ‡¤• |
Pregravid obesity index pregnancy (n) | 29 (5.9%) | 9 (12.2%) ¶ | 10 (10.9%) | 17 (17.0%) ‡ |
Pregravid overweight index pregnancy (n) | 95 (19.3%) | 15 (20.3%) | 21 (22.9%) | 39 (39.0%) ‡¤• |
Maternal age index pregnancy (y) | 30 (27–33) | 30 (27–33) | 31 (28–34) § | 30 (27–33) |
Standard 75 g OGTT index pregnancy, gestational age (wg) | 27.0 (26.0–27.0) | 26.5 (26.0–27.0) | 27.0 (26.0–27.0) §† | 27.0 (26.0–27.0) |
Standard 75 g OGTT index pregnancy, FG (mg/dL) | 80.0 (76.0–84.0) | 82.0 (78.0–87.8) ¶ | 92.0 (85.0–94.0) §† | 93.00 (84.0–97.0) ‡¤• |
Standard 75 g OGTT index pregnancy, 1 h-PLG (mg/dL) | 122.0 (106.0–141.0) | 133.5 (119.8–152.0) ¶ | 168.0 (144.0–191.3) §† | 182.0 (162.3–192.0) ‡¤ |
Standard 75 g OGTT index pregnancy, 2 h-PLG (mg/dL) | 100.0 (88.0–113.0) | 107.5 (94.0–119.5) ¶ | 146.00 (120.8–168.0) §† | 156.5 (123.8–182.3) ‡¤ |
Standard 75 g OGTT index pregnancy, AUC glucose (mg·h/dL) | 213.0 (192.0–235.5) | 232.3 (204.7–250.6) ¶ | 287.8 (255.0–317.4) §† | 302.0 (275.4–323.0) ‡¤• |
Standard 75 g OGTT index pregnancy, gestational weight gain (kg) | 7.0 (5.0–9.0) | 7.0 (5.0–9.0) | 7.0 (5.0–9.0) | 6.0 (3.0–8.0) ‡ |
Gestational weight gain at the last follow-up before delivery (kg) | - | - | 10.0 (7.3–12.0) | 8.0 (5.0–9.8) |
Insulin therapy index pregnancy (n) | - | - | 3 (10% *) | 11 (42.3% *) • |
Macrosomic birth index pregnancy (n) | 2 (0.4%) | 1 (1.4%) | 0 (0%) | 1 (1.0%) |
Preterm birth index pregnancy (n) | 3 (0.6%) | 3 (4.1%) ¶ | 5 (5.4%) § | 1 (1.0%) |
Maternal age subsequent pregnancy (y) | 33 (30–36) | 33 (31–36) | 34 (31–37) § | 33 (31–36) |
Interpregnancy age change (y) | 3.0 (2.0–5.0) | 4.0 (2.3–5.0) | 3.0 (2.0–4.0) §† | 3.0 (2.0–4.0) ‡¤ |
Pregravid body weight subsequent pregnancy (kg) | 60.8 (55.0–70.0) | 63.5 (56.6–73.8) | 62.5 (55.8–70.0) | 69.0 (59.0–77.3) ‡ |
Pregravid obesity subsequent pregnancy (n) | 46 (9.3%) | 13 (17.6%) ¶ | 10 (10.9%) | 19 (19.0%) ‡ |
Pregravid overweight subsequent pregnancy (n) | 125 (25.4%) | 19 (25.7%) | 22 (23.9%) | 38 (38.0%) ‡• |
Pregravid BMI subsequent pregnancy (kg/m2) | 22.9 (20.8–25.9) | 24.4 (21.7–27.6) ¶ | 23.5 (21.1–26.7) | 26.2 (23.0–29.5) ‡• |
Interpregnancy body weight change (kg) | 2.0 (0.0–4.0) | 3.0 (−0.4–7.5) | 0.0 (−1.0–3.0) §† | 0.0 (−1.0–5.0) ¤ |
Interpregnancy BMI change (kg/m2) | 0.7 (0.0–1.7) | 1.1 (−0.2–2.7) | 0.0 (−0.4–1.2) §† | 0.5 (−0.3–1.6) ¤ |
ISS High Risk for GDM in subsequent pregnancy (n) | 46 (9.3%) | 17 (23.0%) ¶ | 92 (100%) §† | 100 (100%) ‡¤ |
Adherence to early OGTT subsequent pregnancy (n) | 4 (8.7%) | 6 (35.3%) ¶ | 52 (56.5%) §† | 63 (63.0%) ‡ |
Early 75 g OGTT subsequent pregnancy, fasting glucose (mg/dL) | 88.5 (87.8–89.0) | 85.5 (81.5–93.3) | 82.7 (79.0–87.0) § | 94.0 (88.0–98.5) • |
Early 75 g OGTT subsequent pregnancy, 1 h-PLG (mg/dL) | 138.0 (135.0–141.8) | 160.0 (147.8–170.8) | 132.5 (115.3–146.3) † | 154.5 (138.0–181.8) • |
Early 75 g OGTT subsequent pregnancy, 2 h-PLG (mg/dL) | 101.5 (99.5–107.0) | 120.5 (109.8–144.0) | 100.0 (91.8–115.0) † | 126.5 (102.5–146.8) • |
Early 75 g OGTT subsequent pregnancy, positive for GDM (n) | 0 (0.0%) | 3 (50.0%) | 0 (0.0%) | 52 (82.5%) |
Standard 75 g OGTT subsequent pregnancy, gestational age (wg) | 26.0 (25.0–27.0) | 26.0 (26.0–27.0) ¶ | 26.0 (25.0–27.0) | 26.0 (25.0–27.0) |
Standard 75 g OGTT subsequent pregnancy, FG (mg/dL) | 80.0 (76.8–84.0) | 92.0 (84.5–95.3) ¶ | 82.0 (78.0–87.0) §† | 92.0 (85.0–96.0) ‡• |
Standard 75 g OGTT subsequent pregnancy, 1 h-PLG (mg/dL) | 124.0 (104.0–144.0) | 173.5 (141.0–186.3) ¶ | 142.0 (122.0–155.0) §† | 184.0 (161.0–201.0) ‡¤• |
Standard 75 g OGTT subsequent pregnancy, 2 h-PLG (mg/dL) | 99.0 (88.0–113.0) | 129.0 (108.5–146.0) ¶ | 107.0 (94.8–120.0) §† | 154.0 (121.0–167.0) ‡¤• |
Standard 75 g OGTT subsequent pregnancy, gestational weight gain (kg) | 7.0 (5.0–9.0) | 6.0 (5.0–9.0) | 6.0 (3.0–9.0) § | 6.0 (4.0–9.0) |
Regression Model | Parameter | Standardized β | Odds Ratio | Lower Bound (95% CI) | Upper Bound (95% CI) | p Value |
---|---|---|---|---|---|---|
New-onset GDM in subsequent pregnancy | Standard 75 g OGTT index pregnancy, 1 h-PLG (mg/dL) * | 0.484 | 1.019 | 1.009 | 1.030 | <0.001 |
Recurrent GDM in subsequent pregnancy | Standard 75 g OGTT index pregnancy, 2 h-PLG (mg/dL) * | 0.762 | 1.028 | 1.002 | 1.054 | 0.035 |
Regression Model | Parameter | Standardized β | Odds Ratio | Lower Bound (95% CI) | Upper Bound (95% CI) | p Value |
---|---|---|---|---|---|---|
New-onset GDM in subsequent pregnancy | Standard 75 g OGTT index pregnancy 1 h-PLG ≥ 130 mg/dL * | 0.914 | 2.496 | 1.507 | 4.133 | <0.001 |
Recurrent GDM in subsequent pregnancy | Standard 75 g OGTT index pregnancy 2 h-PLG ≥ 153 mg/dL * | 0.795 | 2.214 | 1.059 | 4.631 | 0.035 |
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Mirabelli, M.; Tocci, V.; Chiefari, E.; Iuliano, S.; Brunetti, F.S.; Misiti, R.; Giuliano, S.; Greco, M.; Foti, D.P.; Brunetti, A. Clinical Risk Factors and First Gestational 75 g OGTT May Predict Recurrent and New-Onset Gestational Diabetes in Multiparous Women. J. Clin. Med. 2024, 13, 5200. https://doi.org/10.3390/jcm13175200
Mirabelli M, Tocci V, Chiefari E, Iuliano S, Brunetti FS, Misiti R, Giuliano S, Greco M, Foti DP, Brunetti A. Clinical Risk Factors and First Gestational 75 g OGTT May Predict Recurrent and New-Onset Gestational Diabetes in Multiparous Women. Journal of Clinical Medicine. 2024; 13(17):5200. https://doi.org/10.3390/jcm13175200
Chicago/Turabian StyleMirabelli, Maria, Vera Tocci, Eusebio Chiefari, Stefano Iuliano, Francesco S. Brunetti, Roberta Misiti, Stefania Giuliano, Marta Greco, Daniela P. Foti, and Antonio Brunetti. 2024. "Clinical Risk Factors and First Gestational 75 g OGTT May Predict Recurrent and New-Onset Gestational Diabetes in Multiparous Women" Journal of Clinical Medicine 13, no. 17: 5200. https://doi.org/10.3390/jcm13175200