title: Estimating risk factors and perinatal outcomes for gestational diabetes and impaired glucose tolerance in teen mothers.
abstract: BACKGROUND
  Our objective was to identify potentially modifiable risk factors and outcomes for gestational diabetes and impaired glucose tolerance in a contemporary American teen population.
  
  
  METHODS
  We conducted a retrospective cohort analysis of all teenage deliveries (≤18 years old) at one institution over a 4-year period with documented oral glucose tolerance testing. All cases of gestational diabetes and impaired glucose tolerance were identified using the Carpenter and Coustan diagnostic criteria and compared with teenage mothers with normal glucose tolerance testing.
  
  
  RESULTS
  Of the 670 included teen deliveries, 668 were either African American or Hispanic/Latino; 31 (5%) were diagnosed with gestational diabetes (n = 5) or impaired glucose tolerance (n = 26). Higher maternal prepregnancy body mass index (34.3 ± 7.8 vs 30.3 ± 6.4, p = 0.001) and morbid obesity (body mass index ≥ 35 kg/m(2) , RR 2.0, 95% CI 1.1-3.6) were associated with gestational diabetes and impaired glucose tolerance. There was no association with weight gain above the Institute of Medicine recommended levels (RR 1.6, 95% CI 0.77-3.4). On postpregnancy follow up, three of the five (60%) teens with gestational diabetes and none of the 26 (0%) teens with impaired glucose tolerance were diagnosed with diabetes mellitus.
  
  
  CONCLUSIONS
  Higher prepregnancy body mass index, especially morbid obesity, places the gravid teen at higher risk for development of gestational diabetes and impaired glucose tolerance in pregnancy. The potentially modifiable nature of these risk factors coupled with the emerging teen obesity epidemic underscores the need for increased public health focus on this problem.
authors.affiliation: Memorial Health University Medical Center, Mercer School of Medicine, Savannah, GA, USA. arthurbaker@memorialhealth.com
authors.forename: Arthur M
authors.initials: AM
authors.lastname: Baker
authors.forename: Sina
authors.initials: S
authors.lastname: Haeri
mesh_terms: D000293:Adolescent; D001741:Black or African American; D015992:Body Mass Index; D016640:Diabetes, Gestational / Q000175:diagnosis / Q000453:epidemiology*; D004219:District of Columbia / Q000453:epidemiology; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology; D006630:Hispanic or Latino; D006801:Humans; D007231:Infant, Newborn; D009767:Obesity, Morbid / Q000150:complications*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011253:Pregnancy in Adolescence / Q000208:ethnology / Q000706:statistics & numerical data; D012189:Retrospective Studies