Age, Obesity, Family History, Previous Gestational Diabetes Are Major Risk Factors for Hyperglycemia in Pregnant Bulgarian Women

Abstract

The frequency of Gestational Diabetes Mellitus (GDM) ranges from 5.2% to 40.4% in different countries. This wide variability is due to numerous risk factors. The aim of the present study was to analyze the frequency and role of some risk factors for the development of Hyperglycemia regarding the Bulgarian population of pregnant women. Material: We screened 547 pregnant women, mean age 30.49±5.12 years, divided into two groups: up to 24 gestational week – g.w. (n-386, 70.6%) and after 24 g.w. (n-161, 29.4%). Methods: BMI before pregnancy and the current one at the time of the study were calculated. A two-hour, 75 g oral glucose tolerance test (OGTT) was performed. Plasma glucose was quantitatively determined using enzymatic reference method with hexokinase (Roche reagent) on Cobas e501 analyzer, in one Central laboratory on the day of the blood sampling. The results were in mmol / l. The statistical analysis was performed using standard SPSS 13.0 for Windows. Results: We showed that 14.4% (n-79/547) of the screened pregnant women have Hyperglycemia in fasted state or during the OGTT test – 7.5% in group up to 24 g.w. versus 31% in group after 24 g.w, P<0.01. The age of the group of pregnant women with Hyperglycemia (n-79) versus the others with Normoglycemia (n-468) was significantly higher - 32.18±5.26 years v.s. 30.21±5.05 years, Р<0.005. The women with a higher BMI before and during pregnancy are significantly at risk of developing glucose tolerance disorders during pregnancy, P<0.0001. Family history of diabetes occurred in 29.1% (n-23/79) of the pregnant women with Hyperglycemia, versus 13.5% (n-63/468) of those with Normoglycemia, P<0.001. There was a significant difference between the incidence of Hyperglycemia in pregnant women with previous GDM compared with those without - 3/79 (3.8%) versus 3/468 (0.6%), Р<0.04. Conclusion: Considering the main significant risk factors for the development of Hyperglycemia during pregnancy, identified in our population in the current screening - advanced maternal age, obesity, family history of diabetes, previous GDM or High blood sugar before pregnancy, verbal screening would be very helpful and would direct us immediately to screening each pregnant woman with any of these risk factors.