Warning signs of pregnancy-related diabetes

2011-05-30

Diabetes stemming from pregnancy can cause a host of problems for baby and mother alike, including birth complications and a higher risk of developing the more serious type 2 diabetes later in life.

In a new study, researchers say they’ve identified a series of routine health measures that can help doctors predict years in advance which women will develop pregnancy-related diabetes, paving the way for lifestyle changes and other early prevention efforts.

Obesity, elevated blood sugar, and high blood pressure were all linked to a higher risk of developing pregnancy-related diabetes, also known as gestational diabetes. The odds were nearly three times higher among overweight and obese women as among those of normal weight, the study found, and the odds were roughly 2.5 times higher among those with slightly elevated blood sugar.

These findings weren’t especially surprising, since high blood sugar and being overweight – along with a family history of the disease – are well-known risk factors for both gestational and type 2 diabetes. What was surprising is that these factors predicted gestational diabetes even though they were measured an average of seven years before the women became pregnant.

In fact, this was the first study to assess the relationship between gestational diabetes and blood-sugar levels before (rather than during) pregnancy. “Not a lot is known about how factors before pregnancy influence a woman’s risk of what happens during pregnancy,” says the lead author of the study, Monique Hedderson, Ph.D., a research scientist with the Kaiser Permanente health-care organization, in Oakland, Calif.

The study “highlights the… need to develop effective weight-management programs for women of reproductive age to help them achieve a healthy weight before pregnancy,” Hedderson adds. “These programs are important both before, during, and after pregnancy, as most women have more than one pregnancy and postpartum for one pregnancy is preconception for another.”

Indeed, in another study published earlier this week, Hedderson and her coauthors found that women who gain weight after a first pregnancy dramatically raise their risk of gestational diabetes in a subsequent pregnancy.

The new study, which appears in the American Journal of Obstetrics and Gynecology, included 580 members of the Kaiser Permanente health plan. Using measurements taken as part of routine checkups, the researchers compared the risk factors of women who went on to develop gestational diabetes with demographically similar women who did not.

Roughly 4% of expecting mothers are diagnosed with gestational diabetes, according to the American Diabetes Association. The condition increases the risk of delivering a large baby and undergoing a Cesarean section, and is also associated with a higher risk of heart disease and type 2 diabetes. Their offspring, meanwhile, are more likely to become obese as children and develop type 2 diabetes.