Maternal metabolic factors and the association with gestational diabetes: A systematic review and meta‐analysis

Maternal metabolic factors and the association with gestational diabetes: A systematic review and meta‐analysis

Gestational diabetes (GDM) is associated with several adverse outcomes for the mother and child. Higher levels of individual lipids are associated with risk of GDM and metabolic syndrome (MetS), a clustering of risk factors also increases risk for GDM. Metabolic factors can be modified by diet and l...

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Published in:Diabetes/metabolism research and reviews Vol. 38; no. 5; pp. e3532 - n/a
Main Authors: Habibi, Nahal, Mousa, Aya, Tay, Chau Thien, Khomami, Mahnaz Bahri, Patten, Rhiannon K., Andraweera, Prabha H., Wassie, Molla, Vandersluys, Jared, Aflatounian, Ali, Bianco‐Miotto, Tina, Zhou, Shao J., Grieger, Jessica A.
Format: Journal Article
Language:English
Published: England Wiley Subscription Services, Inc 01-07-2022
Subjects:
Blood pressure
Body mass index
Body weight
Body weight loss
Cholesterol
Diabetes mellitus
Gestational diabetes
glucose
Lipid metabolism
lipids
Meta-analysis
Metabolic syndrome
Metabolism
Obesity
Overweight
Pregnancy
Reviews
Risk factors
Systematic review
Triglycerides
Weight control
metabolic syndrome
glucose
lipids
body mass index
gestational diabetes
pregnancy
meta-analysis
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Summary:Gestational diabetes (GDM) is associated with several adverse outcomes for the mother and child. Higher levels of individual lipids are associated with risk of GDM and metabolic syndrome (MetS), a clustering of risk factors also increases risk for GDM. Metabolic factors can be modified by diet and lifestyle. This review comprehensively evaluates the association between MetS and its components, measured in early pregnancy, and risk for GDM. Databases (Cumulative Index to Nursing and Allied Health Literature, PubMed, Embase, and Cochrane Library) were searched from inception to 5 May 2021. Eligible studies included ≥1 metabolic factor (waist circumference, blood pressure, fasting plasma glucose (FPG), triglycerides, and high‐density lipoprotein cholesterol), measured at <16 weeks' gestation. At least two authors independently screened potentially eligible studies. Heterogeneity was quantified using I2. Data were pooled by random‐effects models and expressed as odds ratio and 95% confidence intervals (CIs). Of 7213 articles identified, 40 unique articles were included in meta‐analysis. In analyses adjusting for maternal age and body mass index, GDM was increased with increasing FPG (odds ratios [OR] 1.92; 95% CI 1.39–2.64, k = 7 studies) or having MetS (OR 2.52; 1.65, 3.84, k = 3). Women with overweight (OR 2.17; 95% CI 1.89, 2.50, k = 12) or obesity (OR 4.34; 95% CI 2.79–6.74, k = 9) also were at increased risk for GDM. Early pregnancy assessment of glucose or the MetS, offers a potential opportunity to detect and treat individual risk factors as an approach towards GDM prevention; weight loss for pregnant women with overweight or obesity is not recommended. Systematic review registration: PROSPERO CRD42020199225.
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ISSN:1520-7552
1520-7560
DOI:10.1002/dmrr.3532