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Cardiometabolic and Mental Health in Women With Early Gestational Diabetes Mellitus: A Prospective Cohort Study

妊娠期糖尿病 医学 糖尿病前期 产科 怀孕 前瞻性队列研究 体质指数 糖尿病 代谢综合征 内科学 妇科 妊娠期 2型糖尿病 内分泌学 遗传学 生物
作者
Dan Yedu Quansah,Justine Gross,Leah Gilbert,Amélie Pauchet,Antje Horsch,Katrien Benhalima,E. Cosson,Jardena J. Puder
出处
期刊:The Journal of Clinical Endocrinology and Metabolism [The Endocrine Society]
卷期号:107 (3): e996-e1008 被引量:8
标识
DOI:10.1210/clinem/dgab791
摘要

Abstract Context Early diagnosis and treatment of gestational diabetes (GDM) may reduce adverse obstetric and neonatal outcomes, especially in high-risk women. However, there is a lack of data for other outcomes. Objective We compared cardiometabolic and mental health outcomes in women with early (eGDM) and classical (cGDM) GDM. Methods This prospective cohort included 1185 All women with cGDM and 76 women with eGDM. The eGDM group had GDM risk factors (BMI >30 kg/m2, family history of diabetes, history of GDM, ethnicity), were tested at <20 weeks gestational age, and diagnosed using American Diabetes Association prediabetes criteria. All women underwent lifestyle adaptations. Obstetric, neonatal, mental, and cardiometabolic outcomes were assessed during pregnancy and postpartum. Results The eGDM group had lower gestational weight gain than cGDM (10.7 ± 6.2 vs 12.6 ± 6.4; P = 0.03) but needed more medical treatment (66% vs 42%; P < 0.001). They had similar rates of adverse maternal and neonatal outcomes, except for increased large-for-gestational-age infants (25% vs 15%; P = 0.02). Mental health during pregnancy and postpartum did not differ between groups. eGDM had more atherogenic postpartum lipid profile than cGDM (P ≤ 0.001). In eGDM, the postpartum prevalence of the metabolic syndrome (MetS) was 1.8-fold, prediabetes was 3.1-fold, and diabetes was 7.4-fold higher than cGDM (waist circumference-based MetS: 62% vs 34%/BMI-based MetS: 46% vs 24%; prediabetes: 47.5% vs 15.3%; diabetes: 11.9% vs 1.6%, all P < 0.001). These differences remained unchanged after adjusting for GDM risk factors. Conclusion Compared with cGDM, eGDM was not associated with differences in mental health, but with increased adverse cardiometabolic outcomes, independent of GDM risk factors and gestational weight gain. This hints to a preexisting risk profile in eGDM.
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