High BMI, hypothyroidism identified as GDM risk factors

  • Giannakou K & al.
  • PLoS ONE
  • 1 Jan 2019

  • International Clinical Digest
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Takeaway

  • Increased BMI and hypothyroidism show a strong, consistent association with gestational diabetes mellitus (GDM).
  • Findings suggest women with known thyroid disease should be offered GDM screening earlier in pregnancy.

Why this matters

  • GDM is associated with increased risks of short- and long-term maternal and infant morbidity.

Study design

  • Umbrella review of 30 papers with data from 61 different meta-analyses.
  • Significant effect defined as P-6, >1000 cases, between-study heterogeneity not large (I2
  • “Highly suggestive” results were >1000 cases, significant effect at P−6, and nominally statistically significant effect in the largest study.
  • Funding: None.

Key results

  • After applying credibility criteria, low vs normal BMI (kg/m2), BMI ~30-35 vs normal weight, BMI >35 vs normal weight, and hypothyroidism (all types) presented convincing evidence for GDM association.
  • Risk factors presenting highly suggestive evidence for GDM include: prepregnancy BMI (continuous variable), overweight vs normal BMI, BMI >30 vs normal weight, overweight vs nonoverweight, obese vs nonobese, snoring, sleep-disordered breathing, PCOS, and family history of diabetes.

Limitations

  • Some studies may have been omitted.
  • All observational data.
  • Possible selective reporting in some studies.

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