title: Heterogeneity of maternal characteristics and impact on gestational diabetes (GDM) risk-Implications for universal GDM screening?
abstract: OBJECTIVE
  To study the incidence of gestational diabetes mellitus (GDM) in relation to phenotypic characteristics and gestational weight gain (GWG) among women at high risk for GDM.
  
  
  METHODS
  This is a secondary analysis of a GDM prevention study (RADIEL), a randomized controlled trial conducted in Finland. 269 women with a history of GDM and/or a pre-pregnancy body mass index (BMI) ≥ 30 kg/m(2) were enrolled before 20 weeks of gestation and divided into four groups according to parity, BMI and previous history of GDM. The main outcome was incidence of GDM.
  
  
  RESULTS
  There was a significant difference in incidence of GDM between the groups (p < 0.001). Women with a history of GDM and BMI <30 kg/m(2) showed the highest incidence (35.9%). At baseline they had fewer metabolic risk factors and by the second trimester they gained more weight. There was no interaction between GWG and GDM outcome and no significant difference in the prevalence of diabetes-associated antibodies.
  
  
  CONCLUSIONS
  Despite a healthier metabolic profile at baseline the non-obese women with a history of GDM displayed a markedly higher cumulative incidence of GDM. GWG and the presence of diabetes-associated antibodies were not associated with GDM occurrence among these high-risk women. Key message Despite a healthier metabolic profile at baseline the non-obese women with previous gestational diabetes mellitus display a markedly higher cumulative incidence of gestational diabetes mellitus.
authors.affiliation: a Department of Obstetrics and Gynecology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland ;
authors.forename: Emilia
authors.initials: E
authors.lastname: Huvinen
authors.affiliation: b Folkhälsan Research Centre, Helsinki, University of Helsinki , Helsinki , Finland ;
authors.forename: Nora Elisabeth
authors.initials: NE
authors.lastname: Grotenfelt
authors.affiliation: b Folkhälsan Research Centre, Helsinki, University of Helsinki , Helsinki , Finland ;|c Department of Chronic Disease Prevention , National Institute for Health and Welfare , Helsinki , Finland ;|d Unit of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital , Helsinki , Finland ;
authors.forename: Johan Gunnar
authors.initials: JG
authors.lastname: Eriksson
authors.affiliation: a Department of Obstetrics and Gynecology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland ;
authors.forename: Kristiina
authors.initials: K
authors.lastname: Rönö
authors.affiliation: a Department of Obstetrics and Gynecology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland ;|e Department of Obstetrics and Gynecology , South-Karelia Central Hospital , Lappeenranta , Finland ;|f Medical Genetics, University of Helsinki and Helsinki University Hospital , Helsinki , Finland ;
authors.forename: Miira Marjuska
authors.initials: MM
authors.lastname: Klemetti
authors.affiliation: g Department of Health and Social Management , University of Eastern Finland , Kuopio , Finland ;|h Group Administration, University of Helsinki and Helsinki University Hospital , Helsinki , Finland ;
authors.forename: Risto
authors.initials: R
authors.lastname: Roine
authors.affiliation: a Department of Obstetrics and Gynecology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland ;
authors.forename: Maritta
authors.initials: M
authors.lastname: Pöyhönen-Alho
authors.affiliation: a Department of Obstetrics and Gynecology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland ;
authors.forename: Aila
authors.initials: A
authors.lastname: Tiitinen
authors.affiliation: j Children's Hospital, University of Helsinki and Helsinki University Hospital , Helsinki , Finland ;
authors.forename: Sture
authors.initials: S
authors.lastname: Andersson
authors.affiliation: a Department of Obstetrics and Gynecology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland ;|f Medical Genetics, University of Helsinki and Helsinki University Hospital , Helsinki , Finland ;|i Institute for Molecular Medicine Finland , Helsinki , Finland ;
authors.forename: Hannele
authors.initials: H
authors.lastname: Laivuori
authors.affiliation: b Folkhälsan Research Centre, Helsinki, University of Helsinki , Helsinki , Finland ;|j Children's Hospital, University of Helsinki and Helsinki University Hospital , Helsinki , Finland ;|k Research Programs Unit, Diabetes and Obesity, University of Helsinki , Helsinki , Finland ;|l Tampere Centre for Child Health Research, Tampere University Hospital , Tampere , Finland ;
authors.forename: Mikael
authors.initials: M
authors.lastname: Knip
authors.affiliation: b Folkhälsan Research Centre, Helsinki, University of Helsinki , Helsinki , Finland ;|d Unit of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital , Helsinki , Finland ;
authors.forename: Anita
authors.initials: A
authors.lastname: Valkama
authors.affiliation: d Unit of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital , Helsinki , Finland ;
authors.forename: Jelena
authors.initials: J
authors.lastname: Meinilä
authors.affiliation: d Unit of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital , Helsinki , Finland ;|m Department of General Practice and Primary Health Care , University of Eastern Finland , Joensuu , Finland.
authors.forename: Hannu
authors.initials: H
authors.lastname: Kautiainen
authors.affiliation: e Department of Obstetrics and Gynecology , South-Karelia Central Hospital , Lappeenranta , Finland ;
authors.forename: Beata
authors.initials: B
authors.lastname: Stach-Lempinen
authors.affiliation: a Department of Obstetrics and Gynecology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland ;
authors.forename: Saila Birgitta
authors.initials: SB
authors.lastname: Koivusalo
mesh_terms: D000328:Adult; D015992:Body Mass Index; D016640:Diabetes, Gestational / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008019:Life Style; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D015430:Weight Gain / Q000502:physiology
keywords: Diabetes-related autoantibodies; gestational diabetes; gestational weight gain; heterogeneity; lifestyle interventions; obesity; screening; type 2 diabetes