OBJECTIVES: To explore the association between maternal gestational diabetes mellitus (GDM) exposure and the development of autism spectrum disorder (ASD) in offspring. METHODS: A case-control study was conducted, recruiting 221 children with ASD and 400 healthy children as controls. Questionnaires and interviews were used to collect information on general characteristics of the children, socio-economic characteristics of the family, maternal pregnancy history, and maternal disease exposure during pregnancy. Multivariate logistic regression analysis was used to investigate the association between maternal GDM exposure and the development of ASD in offspring. The potential interaction between offspring gender and maternal GDM exposure on the development of ASD in offspring was explored. RESULTS: The proportion of maternal GDM was significantly higher in the ASD group compared to the control group (16.3% vs 9.4%, P=0.014). After adjusting for variables such as gender, gestational age, mode of delivery, parity, and maternal education level, maternal GDM exposure was a risk factor for ASD in offspring (OR=2.18, 95%CI: 1.04-4.54, P=0.038). On the basis of adjusting the above variables, after further adjusting the variables including prenatal intake of multivitamins, folic acid intake in the first three months of pregnancy, and assisted reproduction the result trend did not change, but no statistical significance was observed (OR=1.94, 95%CI: 0.74-5.11, P=0.183). There was an interaction between maternal GDM exposure and offspring gender on the development of ASD in offspring (P<0.001). Gender stratified analysis showed that only in male offspring of mothers with GDM, the risk of ASD was significantly increased (OR=3.67, 95%CI: 1.16-11.65, P=0.027). CONCLUSIONS Maternal GDM exposure might increase the risk of ASD in offspring. There is an interaction between GDM exposure and offspring gender in the development of ASD in offspring.
Child ; Female ; Pregnancy ; Humans ; Male ; Diabetes, Gestational/etiology* ; Autism Spectrum Disorder/etiology* ; Case-Control Studies ; Gestational Age ; Mothers

Children born to mothers with gestational diabetes mellitus (GDM) are more likely to exhibit congenital malformations, high birth weight, and obesity and have an increased risk of developing type 2 diabetes in later life. Children who are exposed to maternal diabetes in utero may be 'programmed' for later development of obesity at a critical period of development. Therefore, the purpose of the present study was to examine the associations among adiposity and systolic blood pressure in children and abnormal maternal glucose levels during pregnancy. A total of 856 mother-child pairs were included in the present retrospective study. Eligible pregnant women underwent a standard 75 g oral glucose tolerance test between 24 and 28 weeks' gestation. Anthropometric characteristics of their children were measured at 6 years of age, including body mass index, the sum of subscapular and tricep skinfold thickness, and systolic blood pressure. The result suggests that children exposed to GDM have higher adiposity; prevention of childhood obesity needs to begin early in life for these children.
Adiposity ; physiology ; Aging ; Child ; China ; epidemiology ; Diabetes, Gestational ; metabolism ; Female ; Humans ; Obesity ; etiology ; Pregnancy ; Prenatal Exposure Delayed Effects ; Risk Factors

BACKGROUNDGestational diabetes mellitus (GDM) is a common complication during pregnancy, and gestational weight gain is one of the major and modifiable risk factors. This study aims to estimate the relationship between the rate of gestational weight gain before diagnosis of GDM and the subsequent risk of GDM.

METHODSA case-control study was conducted with 90 GDM cases and 165 women in the control group from May 2012 to August 2012 at Peking University First Affiliated Hospital. GDM was diagnosed according to the standards issued by the Ministry of Health of China in 2011. The plasma glucose levels, weights, and covariate data of the women were obtained based on medical records. Univariate analysis and unconditional Logistic regression model were used to estimate the associations.

RESULTSAfter adjusting for age at delivery, parity, and pre-pregnancy body mass index, the risk of GDM increased with increasing rates of gestational weight gain. Compared with the lower rate of gestational weight gain (less than 0.28 kg per week), a rate of weight gain of 0.28 kg per week or more was associated with increased risk of GDM (odds ratio: 2.03; 95% confidence interval: 1.15 to 3.59). The association between the rate of gestational weight gain and GDM was primarily attributed to the increased weight gain in the first trimester.

CONCLUSIONHigh rates of gestational weight gain, particular during early pregnancy, may increase a woman's risk of GDM.

Adult ; Case-Control Studies ; Diabetes, Gestational ; epidemiology ; etiology ; Female ; Humans ; Pregnancy ; Weight Gain ; physiology

INTRODUCTIONWomen with previous gestational diabetes mellitus (PGDM) are at increased risk of future glucose intolerance. This study aimed to determine the prevalence of prediabetes and type 2 diabetes mellitus (T2DM), and the associated antenatal and historical risk factors among women with PGDM.

METHODSThis was a cross-sectional study conducted at University Malaya Medical Centre, Kuala Lumpur, Malaysia. A 75-g 2-hour oral glucose tolerance test was performed in a cohort of multiethnic women with PGDM. Body mass index, waist and hip circumferences, fasting lipid profile and blood pressure were obtained. Data pertaining to the index gestational diabetes mellitus (GDM) were obtained from medical records and interviews.

RESULTS448 women were enrolled in the study. The prevalence of prediabetes and T2DM was 26.2% and 35.5%, respectively. On multinomial logistic regression analysis, fasting plasma glucose at diagnosis of index GDM and duration lapse after index GDM were shown to be significantly higher in women with isolated impaired fasting glucose (IFG), combined IFG/impaired glucose tolerance and T2DM, as compared to women with normal glucose tolerance (p < 0.05). 2-hour plasma glucose at diagnosis of index GDM was significantly higher only in women who progressed to T2DM when compared to those that remained normal glucose tolerant (p < 0.05).

CONCLUSIONIn this study, duration lapse after index GDM, fasting plasma glucose and 2-hour plasma glucose at diagnosis of index GDM were important risk factors for early identification of women at high risk for future glucose intolerance. These may be useful for developing potential preventive strategies.

Adult ; Blood Glucose ; metabolism ; Body Mass Index ; Cross-Sectional Studies ; Diabetes, Gestational ; blood ; Female ; Glucose Intolerance ; blood ; epidemiology ; etiology ; Glucose Tolerance Test ; Humans ; Malaysia ; epidemiology ; Postpartum Period ; blood ; Prediabetic State ; epidemiology ; etiology ; Pregnancy ; Prevalence ; Risk Factors

No abstract available.
Diabetes Mellitus, Type 2/genetics ; Diabetes, Gestational/*etiology/genetics ; Female ; Humans ; Infant, Newborn ; Korea ; Male ; Pregnancy ; Risk Factors

OBJECTIVEAbnormal glucose metabolism during pregnancy can result in significant adverse outcomes for newborns. This study was designed to investigate the effect of different degrees of impaired glucose tolerance on newborns.

METHODSGlucose challenge test (GCT) and oral glucose tolerance test (OGTT) were performed in pregnant women at 24-28 weeks of gestation. Based on the results of the two tests, their newborn infants were classified into five groups: gestational diabetes mellitus (GDM, n=182), gestational impaired oral glucose tolerance [GIGT, subdividing into GIGT 1 h (n=57) and GIGT 2-3 h groups (n=156)based on the occurrence time of abnormal blood glucose after glucose load], GCT abnormal but OGTT normal (only GCT abnormal, n=38) and normal glucose tolerance (control, n=1 025). The perinatal outcomes were compared among the five groups.

RESULTSThe incidences of macrosomia, large for gestational age (LGA), small for gestational age (SGA), neonatal hypoglycemia and premature birth in the GIGT (1 h) group were significantly higher than those in the control group, but similar to those in the GDM group. The incidences of macrosomia, SGA, neonatal hypoglycemia and premature birth in the GIGT (2-3 h) and the only GCT abnormal groups significantly decreased as compared with those in the GDM group, and similar to those in the control group. GIGT (1 h ) group showed higher incidence of neonatal hypoglycemia and premature birth than the GIGT (2-3 h) and the only GCT abnormal groups.

CONCLUSIONSDifferent degrees of maternal impaired glucose tolerance have different effects on newborns. As maternal GDM, maternal GIGT (1 h) may increase the risk of macrosomia, LGA, SGA, neonatal hypoglycemia and premature birth.

Diabetes, Gestational ; metabolism ; Female ; Fetal Macrosomia ; etiology ; Glucose ; metabolism ; Glucose Intolerance ; complications ; Glucose Tolerance Test ; Humans ; Hypoglycemia ; etiology ; Infant, Newborn ; Male ; Pregnancy ; Premature Birth ; etiology ; Retrospective Studies

BACKGROUNDWomen with a history of gestational diabetes mellitus (GDM) are at higher risk of future development of diabetes. This study investigated the risk factors associated with early postpartum abnormal glucose regulation (AGR) among Chinese women with a history of GDM.

METHODSA total of 186 women with a history of GDM were screened for early postpartum AGR at 6-8 weeks after delivery. Those with AGR were given lifestyle intervention therapy and reevaluated in 6-12 months. The demographic, anthropometric, prenatal and delivery data were recorded. The plasma high-sensitivity C-reactive protein (HsCRP) and lipid concentration were measured, and insulin secretion were analyzed. Insulinogenic index Deltains30'/DeltaBG30', the homeostasis model assessment index (HOMA)-B, and HOMA-IR were calculated. Multiple regression analysis was performed to identify the risk factors.

RESULTSOf the GDM women 28.0% (52/186) had AGR at 6-8 weeks after delivery; 45.2% (17/40) of these AGR women reminded abnormal after 6-12 month lifestyle intervention. Compared to the women who reverted to normal, women with consistent AGR showed significantly lower fasting insulin concentration, lower Deltains30'/DeltaBG30' as well as lower HOMA-B. No significant differences in age, body mass index (BMI), waist circumference, blood pressure, lipid level, HsCRP and HOMA-IR were observed between the two groups. Pre-pregnancy BMI = 25 kg/m(2), fasting glucose level = 5.6 mmol/L and/or 75 g oral glucose tolerance test (OGTT) 2 hours glucose level = 11.1 mmol/L during pregnancy were predictors for the AGR at 6-8 weeks after delivery. Deltains30'/DeltaBG30 = 1.05 was a significant risk contributor to the consistent early postpartum AGR.

CONCLUSIONThere is a high incidence of early postpartum AGR among Chinese woman with prior GDM. Beta-cell dysfunction, rather than insulin resistance or inflammation, is the predominant contributor to the early onset and consistent AGR after delivery.

Adult ; Asian Continental Ancestry Group ; China ; Diabetes Mellitus, Type 2 ; etiology ; Diabetes, Gestational ; Female ; Humans ; Insulin-Secreting Cells ; physiology ; Pregnancy ; Puerperal Disorders ; etiology ; Risk Factors

OBJECTIVETo identify risk factors for gestational diabetes mellitus (GDM) in women and to study the contribution of family history of type-2 diabetes to the risk for DDM.

METHODSA case-control study was performed in 85 women with GDM and 177 cases controls. Univariate and multivariate logistic regression and log-linear model were used to identify risk factors of GDM.

RESULTSMultivariate logistic regression showed that obesity before pregnancy, family history of type-2 diabetes, birth weight of pregnant women, age, fasting plasma level of triglyceride, physical inactivity, etc. all were risk factors for GDM. Analysis with log-linear model showed that parents' (father's or mother's) history of type-2 diabetes associated with GDM, with P-values of 0.012 and 0.017, respectively. Prevalence of diabetes in the mothers of proband with GDM was 9.41%, as compared with that in the fathers of proband with GDM 8.24%, with no statistical significance.

CONCLUSIONSObesity before gestation, family history of type-2 diabetes, low birth weight of mother, age, increased fasting plasma level of triglyceride, as well as parents' history of type-2 diabetes, all were risk factors for GDM. Physical exercise was found to be a protective factor for GDM. Mother's history of type-2 diabetes did not differ from father's in contributing to the onset of GDM in their offspring.

Adult ; Birth Weight ; Diabetes Mellitus ; genetics ; Diabetes, Gestational ; etiology ; Exercise ; Female ; Humans ; Logistic Models ; Obesity ; complications ; Pregnancy ; Risk Factors ; Triglycerides ; blood