Maternal Height, Gestational Diabetes Mellitus and Pregnancy Complications.
Maternal Height, Gestational Diabetes Mellitus and Pregnancy Complications.
Aims: To explore the glucose-overload hypothesis of artefactual gestational diabetes (GDM) diagnosis in shorter women during oral glucose tolerance testing (OGTT), by investigating associations between height and maternal glycemia; and GDM and pregnancy complications in height-groups. Methods: Women from GUSTO (n = 1100, 2009–2010) and NUH (n = 4068, 2017–2018) cohorts underwent a mid-gestation two and three time-point 75 g 2-hour OGTT, respectively. GDM-related complications (hypertensive disorders of pregnancy, preterm delivery, emergency cesarean section, neonatal intensive care unit admission, macrosomia, birthweight) were compared within shorter and taller groups, dichotomized by ethnic-specific median height. Results: Using WHO-1999 criteria, 18.8% (GUSTO) to 22.9% (NUH) of women were diagnosed with GDM-1999; and by WHO-2013 criteria, 21.9% (NUH) had GDM-2013. Each 5-cm height increment was inversely associated with GDM-1999 (adjusted odds ratio [aOR, 95% CI] = 0.81 [0.76–0.87], 2-h glycemia (adjusted β [aβ, 95% CI] = -0.171 mmol/L [-0.208, -0.135]) and 1-h glycemia (aβ = -0.160 mmol/L [-0.207, -0.112]). The inverse association between height and 2-h glycemia was most marked in “Other” ethnicities (Eurasians/Caucasians/mixed/other Asians) and Indians, followed by Chinese, then Malays. Compared with non-GDM, GDM-1999 was associated with preterm delivery (aOR = 1.76 [1.19–2.61]) and higher birthweight (aβ = 57.16 g [20.95, 93.38]) only among taller but not shorter women. Conclusions: Only taller women had an increased odds of GDM-related pregnancy complications. An artefactual GDM diagnosis due to glucose-overload among shorter women is plausible.
Blood glucose, Cohort study, Gestational diabetes mellitus, Glucose tolerance test, Pregnancy complications, Standing height
Chu, Anne H.Y.
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Yuan, Wen Lun
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Loy, See Ling
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Soh, Shu-E.
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Bernard, Jonathan Y.
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Tint, Mya Thway
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Ho-Lim, Sarah S T
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Goh, Huecin
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Ramasamy, Adaikalavan
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Kumar, Mukkesh
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Goh, Claire
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Ang, Li Ting
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Shek, Lynette Pei-Chi
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Chong, Yap-Seng
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Tan, Kok Hian
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Su, Lin Lin
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Biswas, Arijit
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Yap, Fabian
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Lee, Yung Seng
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Chi, Claudia
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Godfrey, Keith
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Eriksson, Johan G.
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Chan, Shiao-Yng
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August 2021
Chu, Anne H.Y.
b47cf1e6-4e6c-4102-92c7-db21f1933c91
Yuan, Wen Lun
bd1a80dc-c82a-4387-b754-72e30dd603a7
Loy, See Ling
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Soh, Shu-E.
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Bernard, Jonathan Y.
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Tint, Mya Thway
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Ho-Lim, Sarah S T
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Goh, Huecin
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Ramasamy, Adaikalavan
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Kumar, Mukkesh
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Goh, Claire
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Ang, Li Ting
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Shek, Lynette Pei-Chi
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Chong, Yap-Seng
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Tan, Kok Hian
4714c94d-334a-42ad-b879-f3aa3a931def
Su, Lin Lin
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Biswas, Arijit
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Yap, Fabian
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Lee, Yung Seng
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Chi, Claudia
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Godfrey, Keith
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Eriksson, Johan G.
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Chan, Shiao-Yng
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Chu, Anne H.Y., Yuan, Wen Lun, Loy, See Ling, Soh, Shu-E., Bernard, Jonathan Y., Tint, Mya Thway, Ho-Lim, Sarah S T, Goh, Huecin, Ramasamy, Adaikalavan, Kumar, Mukkesh, Goh, Claire, Ang, Li Ting, Shek, Lynette Pei-Chi, Chong, Yap-Seng, Tan, Kok Hian, Su, Lin Lin, Biswas, Arijit, Yap, Fabian, Lee, Yung Seng, Chi, Claudia, Godfrey, Keith, Eriksson, Johan G. and Chan, Shiao-Yng
(2021)
Maternal Height, Gestational Diabetes Mellitus and Pregnancy Complications.
Diabetes Research and Clinical Practice, 178, [108978].
(doi:10.1016/j.diabres.2021.108978).
Abstract
Aims: To explore the glucose-overload hypothesis of artefactual gestational diabetes (GDM) diagnosis in shorter women during oral glucose tolerance testing (OGTT), by investigating associations between height and maternal glycemia; and GDM and pregnancy complications in height-groups. Methods: Women from GUSTO (n = 1100, 2009–2010) and NUH (n = 4068, 2017–2018) cohorts underwent a mid-gestation two and three time-point 75 g 2-hour OGTT, respectively. GDM-related complications (hypertensive disorders of pregnancy, preterm delivery, emergency cesarean section, neonatal intensive care unit admission, macrosomia, birthweight) were compared within shorter and taller groups, dichotomized by ethnic-specific median height. Results: Using WHO-1999 criteria, 18.8% (GUSTO) to 22.9% (NUH) of women were diagnosed with GDM-1999; and by WHO-2013 criteria, 21.9% (NUH) had GDM-2013. Each 5-cm height increment was inversely associated with GDM-1999 (adjusted odds ratio [aOR, 95% CI] = 0.81 [0.76–0.87], 2-h glycemia (adjusted β [aβ, 95% CI] = -0.171 mmol/L [-0.208, -0.135]) and 1-h glycemia (aβ = -0.160 mmol/L [-0.207, -0.112]). The inverse association between height and 2-h glycemia was most marked in “Other” ethnicities (Eurasians/Caucasians/mixed/other Asians) and Indians, followed by Chinese, then Malays. Compared with non-GDM, GDM-1999 was associated with preterm delivery (aOR = 1.76 [1.19–2.61]) and higher birthweight (aβ = 57.16 g [20.95, 93.38]) only among taller but not shorter women. Conclusions: Only taller women had an increased odds of GDM-related pregnancy complications. An artefactual GDM diagnosis due to glucose-overload among shorter women is plausible.
Text
MainDoc_Height_GDM_DRCP_revised_22Jun
- Accepted Manuscript
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Accepted/In Press date: 19 July 2021
Published date: August 2021
Additional Information:
Funding Information:
The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [KMG has received reimbursement for speaking at conferences sponsored by companies selling nutritional products. YSC, KMG and SYC are part of an academic consortium that has received research funding from Abbott Nutrition, Nestle and Danone. The other authors have no financial or personal conflict of interest to declare.]
Funding Information:
This research is supported by the Singapore National Research Foundation under its Translational and Clinical Research (TCR) Flagship Programme and administered by the Singapore Ministry of Health’s National Medical Research Council (NMRC), Singapore - NMRC/TCR/004-NUS/2008; NMRC/TCR/012-NUHS/2014. Additional funding is provided by the Singapore Institute for Clinical Sciences (SICS) – Agency for Science Technology and Research (A*STAR). KMG is supported by the UK Medical Research Council (MC_UU_12011/4), the National Institute for Health Research (NIHR Senior Investigator (NF-SI-0515–10042) and NIHR Southampton Biomedical Research Centre (IS-BRC-1215–20004)), the European Union (Erasmus + Project ImpENSA 598488-EPP-1–2018-1-DE-EPPKA2-CBHE-JP), British Heart Foundation (RG/15/17/3174) and the US National Institute On Aging of the National Institutes of Health (Award No. U24AG047867). The study sponsor/funder was not involved in the design of the study; the collection, analysis, and interpretation of data; writing the report; and did not impose any restrictions regarding the publication of the report.
Publisher Copyright:
© 2021 Elsevier B.V.
Keywords:
Blood glucose, Cohort study, Gestational diabetes mellitus, Glucose tolerance test, Pregnancy complications, Standing height
Identifiers
Local EPrints ID: 450645
URI: http://eprints.soton.ac.uk/id/eprint/450645
ISSN: 0168-8227
PURE UUID: 08d66e00-1816-422f-9011-72ac7fe331e4
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Date deposited: 05 Aug 2021 16:32
Last modified: 17 Mar 2024 06:44
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Contributors
Author:
Anne H.Y. Chu
Author:
Wen Lun Yuan
Author:
See Ling Loy
Author:
Shu-E. Soh
Author:
Jonathan Y. Bernard
Author:
Mya Thway Tint
Author:
Sarah S T Ho-Lim
Author:
Huecin Goh
Author:
Adaikalavan Ramasamy
Author:
Mukkesh Kumar
Author:
Claire Goh
Author:
Li Ting Ang
Author:
Lynette Pei-Chi Shek
Author:
Yap-Seng Chong
Author:
Kok Hian Tan
Author:
Lin Lin Su
Author:
Arijit Biswas
Author:
Fabian Yap
Author:
Yung Seng Lee
Author:
Claudia Chi
Author:
Johan G. Eriksson
Author:
Shiao-Yng Chan
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