TY - JOUR
T1 - Maternal metabolic factors and the association with gestational diabetes
T2 - A systematic review and meta-analysis
AU - Habibi, Nahal
AU - Mousa, Aya
AU - Tay, Chau Thien
AU - Khomami, Mahnaz Bahri
AU - Patten, Rhiannon K.
AU - Andraweera, Prabha H.
AU - Wassie, Molla
AU - Vandersluys, Jared
AU - Aflatounian, Ali
AU - Bianco-Miotto, Tina
AU - Zhou, Shao J.
AU - Grieger, Jessica A.
N1 - Funding Information:
We greatly acknowledge the guidance from Dr. Shamil Cooray for the development of the search strategy, and Dr. Rui Wang, for statistical support. Nahal Habibi and Jessica A. Grieger have financial support from the National Health and Medical Research Council (NHMRC) Ideas Grant, awarded to Jessica A. Grieger (GNT 2009038). Aya Mousa is supported by a biomedical research fellowship provided by the NHMRC of Australia (GNT 1161871). CTT holds a scholarship from the Centre of Research Excellence in PCOS and Research Training Program Scholarship from the Commonwealth of Australia.
Publisher Copyright:
© 2022 The Authors. Diabetes/Metabolism Research and Reviews published by John Wiley & Sons Ltd.
PY - 2022/7
Y1 - 2022/7
N2 - 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.
AB - 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.
KW - body mass index
KW - gestational diabetes
KW - glucose
KW - lipids
KW - meta-analysis
KW - metabolic syndrome
KW - pregnancy
UR - http://www.scopus.com/inward/record.url?scp=85128715368&partnerID=8YFLogxK
U2 - 10.1002/dmrr.3532
DO - 10.1002/dmrr.3532
M3 - Review Article
C2 - 35421281
AN - SCOPUS:85128715368
SN - 1520-7560
VL - 38
JO - Diabetes/Metabolism Research and Reviews
JF - Diabetes/Metabolism Research and Reviews
IS - 5
M1 - e3532
ER -