Mild gestational hyperglycaemia as a risk factor for metabolic syndrome in pregnancy and adverse perinatal outcomes.
OBJECTIVE
The aims of this study were to evaluate the prevalence of metabolic syndrome (MS) in a cohort of pregnant women with a wide range of glucose tolerance, pre-pregnancy risk factors for MS during pregnancy and the effects of MS in the occurrence of adverse perinatal outcomes.


METHODS
One hundred and thirty six women with positive screening for gestational diabetes (GDM) were classified by two diagnostic methods: glycaemic profile and 100 g oral glucose tolerance test (OGTT) as normoglycaemic, mild gestational hyperglycaemic, GDM, and overt GDM. Markers of insulin resistance were measured between 24-28 and 36th week of gestation, and 6 weeks after delivery.


RESULTS
The prevalence of MS was 0; 20.0; 23.5 and 36.4% in normoglycaemic, mild hyperglycaemic, GDM and overt GDM groups, respectively. Previous history of GDM with or without insulin use, body mass index (BMI) > or = 25, hypertension, family history of diabetes in first-degree relatives, non-Caucasian ethnicity, history of prematurity and polyhydramnios were statistically significant pre-pregnancy predictors for MS in the index pregnancy, that by its turn increased the occurrence of adverse perinatal outcomes (p = 0.01).


CONCLUSIONS
The prevalence of MS increases with the worsening of glucose tolerance and is an independent predictor of adverse perinatal outcomes; impaired glycaemic profile identifies pregnancies with important metabolic abnormalities that are linked to the occurrence of adverse perinatal outcomes even in the presence of a normal OGTT, in patients that are not currently classified as having GDM.
Negrato
Carlos Antonio
CA
School of Medicine from Botucatu, São Paulo, UNESP, Brazil. carlosnegrato@uol.com.br
Jovanovic
Lois
L
Tambascia
Marcos Antonio
MA
Calderon
Iracema de Mattos Paranhos
Ide M
Geloneze
Bruno
B
Dias
Adriano
A
Rudge
Marilza Vieira Cunha
MV
D000328:Adult; D001827:Body Height; D015992:Body Mass Index; D001938:Brazil; D003920:Diabetes Mellitus / Q000235:genetics; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000097:blood*; D007182:Income; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology*; D009679:Nuclear Family; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood* / Q000453:epidemiology; D011256:Pregnancy Outcome; D015995:Prevalence; D012307:Risk Factors