Incidence and risk factors for hyperglycemia in pregnancy among nulliparous women: A Brazilian multicenter cohort study

PLoS One. 2020 May 13;15(5):e0232664. doi: 10.1371/journal.pone.0232664. eCollection 2020.

Abstract

Objective: To assess the incidence and risk factors for hyperglycemia in pregnancy in a cohort of Brazilian nulliparous pregnant women.

Materials and methods: 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.

Results: 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.

Conclusions: 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.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Brazil / epidemiology
  • Diabetes, Gestational / epidemiology*
  • Female
  • Humans
  • Hyperglycemia / epidemiology*
  • Incidence
  • Overweight / epidemiology
  • Pregnancy
  • Pregnancy Complications / epidemiology*
  • Risk Factors
  • Young Adult

Grants and funding

This study was jointly funded by the Bill and Melinda Gates Foundation (grant OPP1107597) and the Brazilian CNPq (grant 401636/2013-5). Both awarded to JGC. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.