Pregravid cardiometabolic risk profile and risk for gestational diabetes mellitus.

Abstract

The purpose of this study was to examine pregravid cardiometabolic profile and subsequent risk of gestational diabetes mellitus (GDM). GDM cases (n = 199) and control subjects (n = 381) were selected from a cohort of women who took part in a multiphasic health checkup examination at Kaiser Permanente from 1984-1996 and who had a subsequent pregnancy and were matched by year and age at multiphasic health checkup examination and age at delivery. Pregravid measurements of serum glucose levels of 100-140 mg/dL, body mass index of ≥ 25.0 kg/m(2), and prehypertension/hypertension level were associated independently with GDM risk (odds ratios [OR], 4.8; 95% confidence interval [CI], 1.7-13.9; OR, 2.7; 95% CI, 1.6-4.3; and OR, 1.5; 95% CI, 1.0-2.3, respectively). The risk of GDM increased with the number of cardiometabolic risk factors (P < .001); adverse levels of both body mass index and glucose were associated with a 4.6-fold increased risk of GDM, compared with women with normal levels (P = .0001). Pregravid cardiometabolic risk profile may help clinicians to identify high-risk women to target for primary prevention or early management of GDM.