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Abstract
Introduction: Gestational diabetes mellitus (GDM) is an hyperglycemia state which is diagnosed during the second or third trimester of pregnancy, that has negative consequences for maternal and fetal health, short and long-term1,2,3. Fetal phenotype is already altered at GDM diagnosis time4,5, therefore is necessary to implement methodologies that allow its early detection.
Aim: To determine first trimester (1T) gyneco-obstetric variables that let GDM early diagnosis in Chilean pregnant women.
Methods: Pregnant women with ≤ 12 gestational weeks (GW) and without pregestational diabetes were recruited in Concepcion, Chile. During 1T, 19 gyneco-obstetric parameters were registered. GDM diagnosis was performed at 24-28 GW, with postload glycemia (75g, 2h) ≥ 140 mg/dL. 1T data of 6 GDM and 33 normal glucose tolerance (NGT) pregnant women were preprocessed by autoscale and explored by principal component analysis.
Results: Principal component 6 (7% variance) allows to clearly distinguish GDM from NGT pregnancies. The gyneco-obstetric variables that are more strongly correlated with GDM are: FTO genotype (rs9939609), previous GDM history, T3 concentration, diastolic pressure, and anti-TR and anti-TPO levels.
Conclusions: The stated 1T variables let to discriminate between pregnant women with and without GDM, hence they have a great potential to be used in GDM early diagnosis.
Keywords: Diabetes, Gestational; Early Diagnosis; Multivariate Analysis; Principal Component Analysis.
Conflict of Interest: The authors declare no conflict of interest.
Acknowledgments: Beca Doctorado Nacional ANID 21190736.
2 Lowe WL, Scholtens DM, Lowe LP, et al. Association of gestational diabetes with maternal disorders of glucose metabolism and childhood adiposity. J Am Med Assoc. 2018;320:1005-16.
3 Lowe WL, Scholtens DM, Kuang A, et al. Hyperglycemia and adverse Pregnancy Outcome follow-up study (HAPO FUS): Maternal gestational diabetes mellitus and childhood glucose metabolism. Diabetes Care. 2019;42:372–80.
4 Sovio U, Murphy HR, Smith GCS. Accelerated fetal growth prior to diagnosis of gestational diabetes mellitus: A prospective cohort study of nulliparous women. Diabetes Care. 2016;39:982–7.
5 Venkataraman H, Ram U, Craik S, et al. Increased fetal adiposity prior to diagnosis of gestational diabetes in South Asians: more evidence for the ‘thin–fat’ baby. Diabetologia. 2017;60:399–405.
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