Pregestational obesity and the risk of glucose intolerance and gestational diabetes in pregnancy

Abstract

Background: Obesity in women in reproductive age is becoming more frequent and it self complicates pregnancy increasing the risk of diseases such as gestational diabetes mellitus (GDM). Aims: To determine the risk of gestational diabetes mellitus (GDM) and impaired glucose tolerance (IGT) according to the progestational body mass index (PGBMI). Methods: Sample of 489 patients, they were classified by PGBMI and underwent an oral glucose tolerance test (OGTT) with 100 g of glucose during 120 minutes. GDM was defined with two altered values in the OGTT and IGT with a single altered value. A chi-square test was applied to determine difference between groups, and we obtained an Odds Ratio (OR), with a confidence level of 95%. Results: 9 patients were low weight, 194 normal weight, 158 overweight and 128 obese, average gestational age 31.3 ± 5.6 weeks. 13% of the patients had GDM, 10.6% had IGT. Overweight women had an OR of 3.81 of developing IGT (95% CI 1.62-8.95) and an OR of 3.7 of developing GDM (95% CI 1.65-8.38), while women with prepregnancy obesity showed an OR of 6.6 of developing ITG (95% CI 2.83-15.66) and an OR of 8.8 of developing GDM (95% CI 4.05-19.51), all compared to women with prepregnancy normal weight. Conclusions: Mexican population has a higher risk of GDM than other populations and also a higher prevalence of overweight and obesity, so that every pregnant woman should be screening for GDM, has a diagnosis and receive treatment, preventing complications and Type 2 Diabetes.