title: Prediction of gestational diabetes early in pregnancy: targeting the long-term complications.
abstract: Gestational diabetes (GD), defined as carbohydrate intolerance with onset or first recognition during pregnancy, has a prevalence of 7% and is a growing problem worldwide. Infants born to mothers with GD are more likely to be large for gestational age, incur traumatic birth injury, require a stay in the intensive care unit and develop postnatal metabolic disturbances. As the worldwide epidemic of obesity worsens, more women are entering pregnancy with metabolic alterations and preexisting insulin resistance, which is heightened by the hormonal milieu of pregnancy. The Hyperglycemia Adverse Pregnancy Outcome (HAPO) study has clearly shown that GD-related complications correlate with glycemic control. We will review the current understanding of the physiology of GD and the screening and treatment guidelines that are commonly utilized in clinical care. In addition, we will discuss the need for development of multiparametric models combining maternal clinical risk factors and biomarkers early in pregnancy to better stratify and predict risk of GD-related complications and offer targeted intervention.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Universidad de los Andes, Santiago, Chile.
authors.forename: Paula J
authors.initials: PJ
authors.lastname: Correa
authors.forename: J Francisco
authors.initials: JF
authors.lastname: Vargas
authors.forename: Sarbattama
authors.initials: S
authors.lastname: Sen
authors.forename: Sebastián E
authors.initials: SE
authors.lastname: Illanes
mesh_terms: D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D048909:Diabetes Complications / Q000517:prevention & control*; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000503:physiopathology*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D011247:Pregnancy; D018570:Risk Assessment
chemical_list: D015415:Biomarkers; D001786:Blood Glucose