ABSTRACT
Background: The aim of the present study was to determine the maternal pre-pregnancy body mass index [BMI], first-trimester fasting blood sugar [FBS], and the combination of [BMI+FBS] cut-points for at-risk pregnant women conceived by assisted reproductive technology [ART] to better predict the risk of developing gestational diabetes mellitus [GDM] in infertile women
Materials and Methods: In this nested case-control study, 270 singleton pregnant women consisted of 135 [GDM] and 135 [non-GDM] who conceived using ART were assessed. The diagnosis of GDM was confirmed by a one-step glucose tolerance test [O-GTT] using 75 g oral glucose. BMI was classified base on World Health Organization [WHO] criteria. The relationship between BMI, FBS, and BMI+FBS with the risk of GDM development was deter- mined by logistic regression and adjusted for confounding factors. Receiver operating characteristic [ROC] curve analysis was performed to assess the value of BMI, FBS, and BMI+FBS for the prediction of GDM
Results: The GDM group had significantly higher age, BMI, family history of diabetes, and history of polycystic ovary syndrome in comparison with the non-GDM group [P<0.05]. Overweight and obese women had 3.27, and 5.14 folds increase in the odds of developing GDM, respectively. There was a 17% increase in the risk of developing GDM with each 1 mg/dl increase in fasting glucose level. The cut points for FBS 84.5 mg/dl [72.9% sensitivity, 74.4% specificity], BMI 25.4 kg/m2 [68.9% sensitivity, 62.8% specificity], and BMI+FBS 111.2 [70.7% sensitivity, 80.6% specificity] was determined
Conclusion: The early screening and high-quality prenatal care should be recommended upon the co-occurrence of high FBS [>/=84.5 mg/dl] in the first-trimester of the pregnancy and the BMI [=25.4 kg/m2] in pre-pregnancy period in women undergone ART. The combination of BMI and FBS is considered a better prediction value