Maternal metabolic factors and the association with gestational diabetes: a systematic review and meta-analysis

Nahal Habibi, Aya Mousa, Chau Thien Tay, Mahnaz Bahri Khomami, Rhiannon K. Patten, Prabha H. Andraweera, Molla Wassie, Jared Vandersluys, Ali Aflatounian, Tina Bianco-Miotto, Shao J. Zhou, Jessica A. Grieger

Research output: Contribution to journalReview articlepeer-review

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Abstract

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 I 2. 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.

Original languageEnglish
Article numbere3532
Number of pages41
JournalDiabetes/Metabolism Research and Reviews
Volume38
Issue number5
Early online date14 Apr 2022
DOIs
Publication statusPublished - Jul 2022
Externally publishedYes

Keywords

  • body mass index
  • gestational diabetes
  • glucose
  • lipids
  • meta-analysis
  • metabolic syndrome
  • pregnancy

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