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
ABSTRACT
Objectives: Polycystic ovary syndrome [PCOS] is a common endocrine disorder related to several metabolic consequences. However, there remains uncertainty regarding the metabolic features of various phenotypes. The aim of this study was to explore the relationship between the prevalence of gestational diabetes mellitus [GDM] and metabolic disorders among the four different phenotypes of PCOS
Methods: A crosssectional study was performed in Royan Institute including 208 pregnant women with a history of infertility and PCOS. Using the diagnostic criteria of the American Diabetes Association [ADA], pregnant women with a documented diagnoses of PCOS were further categorized into four different phenotypes [A, B, C, and D] as defined by the Rotterdam criteria
Results: The prevalence of GDM failed to demonstrate a significant relationship among the four phenotypes of PCOS. The mean levels of fasting blood sugar, plasma glucose concentrations at three hours [following the 100 g oral glucose tolerance test] and triglyceride levels were significantly higher in phenotype B compared to the remaining phenotypes [p < 0.050]. There was a statistically significant difference between the mean free testosterone level and phenotypes A and C groups [1.8+/-1.6 vs. 1.1+/-1.0, p = 0.003]
Conclusions: Women with a known diagnosis of PCOS who exhibited oligo/ anovulation and hyperandrogenism demonstrated an increase of metabolic disorders. These results suggest that metabolic screening, before conception or in the early stages of pregnancy, can be beneficial particularly in women with PCOS phenotypes A and B. Early screening and identification may justify enhanced maternal fetal surveillance to improve maternal and fetal morbidity among women affected with PCOS