title: Gestational diabetes: Glycaemic predictors for fetal macrosomia and maternal risk of future diabetes.
abstract: OBJECTIVE
  To investigate how glucose levels at diagnosis of gestational diabetes (GDM) are associated with infant birth weight and long-term risk of manifest diabetes mellitus in the mother.
  
  
  METHODS
  In a case control study GDM pregnancies (n=2085) were compared with non-GDM pregnancies matched for day of delivery and obstetric unit (n=3792). GDM was defined as capillary blood glucose (cB-glucose) ≥9.0mmol/l (plasma glucose ≥10.0mmol/l) after a 75g oral glucose tolerance test (OGTT). The GDM cohort were followed up 8.5-13.5yrs after initial diagnosis with a questionnaire, answered by 1324 GDM women (65%).
  
  
  RESULTS
  GDM women had higher mean infant birth-weight compared with controls (3682g vs. 3541g, P<0.001). In multiple linear regression analysis, birth weight was positively correlated to fasting cB-glucose at GDM diagnosis (P<0.001), increased week of gestation (P<0.001) and BMI before pregnancy (P<0.003), while 2h OGTT cB-glucose values ≥9.0mmol/l were not related. Infants born to mothers with fasting cB-glucose ≤4.5mmol/l had no increased mean birth-weight or macrosomia (≥4500g) compared to controls. In the follow up 334/1324 women (25%) of the GDM women had developed diabetes, 215 type 2 diabetes, 46 type 1 diabetes and 72 unclassified diabetes. In logistic regression fasting cB-glucose and 2h OGTT cB-glucose at diagnosis of GDM as well as BMI >25 and origin outside Europe were risk factors for manifest diabetes.
  
  
  CONCLUSIONS
  Fasting blood glucose at diagnosis of GDM gives important information besides 2h OGTT glucose about pregnancy outcome and future risk for maternal diabetes.
authors.affiliation: Department of Endocrinology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; Department of Endocrinology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
authors.forename: Jeanette
authors.initials: J
authors.lastname: Wahlberg
authors.affiliation: Department of Endocrinology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
authors.forename: Bertil
authors.initials: B
authors.lastname: Ekman
authors.affiliation: Department of Public Health and Clinical Medicine, Epidemiology, Umeå University, Umeå, Sweden.
authors.forename: Lennarth
authors.initials: L
authors.lastname: Nyström
authors.affiliation: Department of Women's and Children's Health, University of Uppsala, Uppsala, Sweden.
authors.forename: Ulf
authors.initials: U
authors.lastname: Hanson
authors.affiliation: Department of Women and Child Health Division of Pediatrics, Karolinska Institute, Stockholm, Sweden.
authors.forename: Bengt
authors.initials: B
authors.lastname: Persson
authors.affiliation: Department of Endocrinology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. Electronic address: hans.arnqvist@liu.se.
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Arnqvist
mesh_terms: D000328:Adult; D001724:Birth Weight; D001786:Blood Glucose / Q000032:analysis*; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D016640:Diabetes, Gestational / Q000097:blood / Q000503:physiopathology*; D005215:Fasting / Q000097:blood; D005260:Female; D005320:Fetal Macrosomia / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D005865:Gestational Age; D005951:Glucose Tolerance Test; D006801:Humans; D016015:Logistic Models; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D001786:Blood Glucose
keywords: Birth weight; Blood glucose; GDM; OGTT; Pregnancy