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Open Access 01-12-2018 | Research article

Future risk of metabolic syndrome in women with a previous LGA delivery stratified by gestational glucose tolerance: a prospective cohort study

Published in: BMC Pregnancy and Childbirth | Issue 1/2018

Abstract

Background

Whether the delivery of a large-for-gestational-age (LGA) infant predicts future maternal metabolic syndrome (MetS) is not known. To this aim, we investigated the incidence of MetS and its components in women with or without a history of gestational diabetes mellitus (GDM) with a view to the birth weight of the offspring.

Methods

Eight hundred seventy six women treated for their pregnancies in Kuopio University Hospital in 1989–2009 underwent a follow-up study (mean follow-up time 7.3 (SD 5.1) years), of whom 489 women with GDM and 385 normoglycemic controls. The women were stratified into two groups according to the newborn’s birth weight: 10-90th percentile (appropriate-for-gestational-age; AGA) (n = 662) and > 90th percentile (LGA) (n = 116). MetS and its components were evaluated in the follow-up study according to the International Diabetes Federation criteria.

Results

LGA vs. AGA delivery was associated with a higher incidence of MetS at follow-up in women with a background of GDM (54.4% vs. 43.6%), but not in women without GDM.

Conclusion

An LGA delivery in women with GDM is associated with a higher risk of future MetS and this group is optimal to study preventive measures for MetS. In contrast, an LGA delivery after a normoglycemic pregnancy was not associated with an increased future maternal MetS risk.

Bellamy L, Casas JP, Hingorani AD, Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet. 2009;373(9677):1773–9.CrossRefPubMed

Kim C, Newton KM, Knopp RH. Gestational diabetes and the incidence of type 2 diabetes: a systematic review. Diabetes Care. 2002;25(10):1862–8.CrossRefPubMed

Hakkarainen H, Huopio H, Cederberg H, Paakkonen M, Voutilainen R, Heinonen S. Post-challenge glycemia during pregnancy as a marker of future risk of type 2 diabetes: a prospective cohort study. Gynecol Endocrinol. 2015;31(7):573–7.PubMed

Xu Y, Shen S, Sun L, Yang H, Jin B, Cao X. Metabolic syndrome risk after gestational diabetes: a systematic review and meta-analysis. PLoS One. 2014;9(1):e87863.CrossRefPubMedPubMedCentral

Hakkarainen H, Huopio H, Cederberg H, Paakkonen M, Voutilainen R, Heinonen S. The risk of metabolic syndrome in women with previous GDM in a long-term follow-up. Gynecol Endocrinol. 2016;32:920–5.CrossRefPubMed

Shah BR, Retnakaran R, Booth GL. Increased risk of cardiovascular disease in young women following gestational diabetes mellitus. Diabetes Care. 2008;31(8):1668–9.CrossRefPubMedPubMedCentral

Retnakaran R, Shah BR. Mild glucose intolerance in pregnancy and risk of cardiovascular disease: a population-based cohort study. CMAJ. 2009;181(6–7):371–6.CrossRefPubMedPubMedCentral

Fraser A, Nelson SM, Macdonald-Wallis C, Cherry L, Butler E, Sattar N, et al. Associations of pregnancy complications with calculated cardiovascular disease risk and cardiovascular risk factors in middle age: the Avon longitudinal study of parents and children. Circulation. 2012;125(11):1367–80.CrossRefPubMedPubMedCentral

Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the international diabetes federation task force on epidemiology and prevention; National Heart, Lung, and Blood Institute; American Heart Association; world heart federation; international atherosclerosis society; and International Association for the Study of obesity. Circulation. 2009;120(16):1640–5.CrossRefPubMed

10.

Pedersen J. Diabetes and Pregnancy: Blood Sugar of Newborn Infants.[dissertation]. Copenhagen, Denmark, Danish Science Press.; 1952.

11.

Berntorp K, Anderberg E, Claesson R, Ignell C, Kallen K. The relative importance of maternal body mass index and glucose levels for prediction of large-for-gestational-age births. BMC Pregnancy Childbirth. 2015;15:280.CrossRefPubMedPubMedCentral

12.

Yu Z, Han S, Zhu J, Sun X, Ji C, Guo X. Pre-pregnancy body mass index in relation to infant birth weight and offspring overweight/obesity: a systematic review and meta-analysis. PLoS One. 2013;8(4):e61627.CrossRefPubMedPubMedCentral

13.

Ludwig DS, Currie J. The association between pregnancy weight gain and birthweight: a within-family comparison. Lancet. 2010;376(9745):984–90.CrossRefPubMedPubMedCentral

14.

Kitajima M, Oka S, Yasuhi I, Fukuda M, Rii Y, Ishimaru T. Maternal serum triglyceride at 24--32 weeks' gestation and newborn weight in nondiabetic women with positive diabetic screens. Obstet Gynecol. 2001;97(5 Pt 1):776–80.CrossRefPubMed

15.

Clausen T, Burski TK, Oyen N, Godang K, Bollerslev J, Henriksen T. Maternal anthropometric and metabolic factors in the first half of pregnancy and risk of neonatal macrosomia in term pregnancies. A prospective study. Eur J Endocrinol. 2005;153(6):887–94.CrossRefPubMed

16.

Boney CM, Verma A, Tucker R, Vohr BR. Metabolic syndrome in childhood: association with birth weight, maternal obesity, and gestational diabetes mellitus. Pediatrics. 2005;115(3):e290–6.CrossRefPubMed

17.

Sankilampi U, Hannila ML, Saari A, Gissler M, Dunkel L. New population-based references for birth weight, length, and head circumference in singletons and twins from 23 to 43 gestation weeks. Ann Med. 2013;45(5–6):446–54.CrossRefPubMed

18.

Alberti KG, Zimmet P, Shaw J, IDF Epidemiology Task Force Consensus Group. The metabolic syndrome--a new worldwide definition. Lancet. 2005;366(9491):1059–62.CrossRefPubMed

19.

Tehrani FR, Hashemi S, Hasheminia M, Azizi F. Follow-up of women with gestational diabetes in the Tehran lipid and glucose study (TLGS): a population-based cohort study. J Obstet Gynaecol Res. 2012;38(4):698–704.CrossRefPubMed

20.

Moses R, Davis W, Rodgers D, Meyer B, Calvert D. The metabolic profile of glucose tolerant women who have had large for gestational age babies. Aust N Z J Obstet Gynaecol. 1997;37(2):177–80.CrossRefPubMed

21.

Spjuth J, Larsson G, Nilsson-Ehle P, Schersten B, Astedt B. Can the birth of a large infant predict risk for atherosclerotic vascular disease in the mother? Diabetologia. 1993;36(2):117–20.CrossRefPubMed

Title: Future risk of metabolic syndrome in women with a previous LGA delivery stratified by gestational glucose tolerance: a prospective cohort study
Publication date: 01-12-2018
Published in: BMC Pregnancy and Childbirth / Issue 1/2018
Electronic ISSN: 1471-2393
DOI: https://doi.org/10.1186/s12884-018-1958-z

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Springer Medicine

Future risk of metabolic syndrome in women with a previous LGA delivery stratified by gestational glucose tolerance: a prospective cohort study

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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