Department of Obstetrics and Gynecology, Botucatu Medical School, Unesp, Botucatu, SP, Brazil.
Department of Obstetrics and Gynecology, University of Campinas (UNICAMP) School of Medical Sciences, Campinas, SP, Brazil.
PLoS One. 2020 May 13;15(5):e0232664. doi: 10.1371/journal.pone.0232664. eCollection 2020.
To assess the incidence and risk factors for hyperglycemia in pregnancy in a cohort of Brazilian nulliparous pregnant women.
This is a secondary analysis of a multicenter cohort study that enrolled 1,008 nulliparous pregnant women at 19-21 weeks. Exclusion criteria included chronic exposure to corticosteroids and previous diabetes. Bivariate and multivariate analyses by Poisson regression were used to identify associated factors.
The incidence of hyperglycemia in pregnancy was 14.9% (150/1,008), and 94.7% of these cases were gestational diabetes mellitus (142/150). Significant associated factors included a family history of diabetes mellitus, maternal overweight or obesity at enrollment, and previous maternal conditions (polycystic ovarian syndrome, thyroid dysfunctions and hypertensive disorders). A BMI ≥ 26.3Kg/m2 (RRadj 1.87 [1.66-2.10]) and a family history of diabetes mellitus (RRadj 1.71 [1.37-2.15]) at enrollment were independent risk factors for HIP.
A family history of diabetes mellitus and overweight or obesity (until 19-21 weeks of gestation) may be used as selective markers for HIP in Brazilian nulliparous women. Given the scarcity of results in nulliparous women, our findings may contribute to determine the optimal diagnostic approach in populations of similar socioeconomic characteristics.
评估巴西初产妇队列中妊娠合并高血糖的发生率及相关因素。
这是一项多中心队列研究的二次分析，共纳入 1008 名 19-21 周的初产妇。排除标准包括长期接受皮质类固醇治疗和既往糖尿病。采用泊松回归的两变量和多变量分析来识别相关因素。
妊娠合并高血糖的发生率为 14.9%（150/1008），其中 94.7%为妊娠期糖尿病（142/150）。显著相关因素包括糖尿病家族史、初诊时超重或肥胖，以及既往的母体疾病（多囊卵巢综合征、甲状腺功能障碍和高血压疾病）。BMI≥26.3kg/m2（RRadj 1.87[1.66-2.10]）和初诊时糖尿病家族史（RRadj 1.71[1.37-2.15]）是 HIP 的独立危险因素。
糖尿病家族史和超重或肥胖（直至 19-21 孕周）可作为巴西初产妇 HIP 的选择性标志物。鉴于初产妇人群的研究结果稀缺，我们的发现可能有助于确定具有类似社会经济特征人群的最佳诊断方法。
