Oral Presentation Australian Diabetes in Pregnancy Society 2018

The influence of maternal age, booking body mass index, and ethnicity on the prevalence of booking gestational diabetes mellitus. Preliminary findings from a multicenter randomized controlled trial (#28)

Jincy Immanuel 1 , David Simmons 1 , Lisa Vizza 1 , Bill Hague 2 , Helena Teede 3 , N Wah Cheung 4 , Emily Hibbert 5 , Christopher Nolan 6 , Michael Peek 7 , Vincent Wong 8 , Jeff Black 9 , Mark Mclean 10 , Alexandra Kautzky-Willer 11 , on behalf of the 12
  1. School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
  2. Robinson Research Institute, The University of Adelaide and Women’s and Children’s Hospital, Adelaide, South Australia, Australia
  3. Monash University, Melbourne, Victoria, Australia
  4. Westmead Hospital, Sydney, NSW, Australia
  5. Nepean Hospital, Sydney, NSW, Australia
  6. Canberra Hospital and Australian National University, Canberra, ACT, Australia
  7. Australian National University, Canberra, ACT, Australia
  8. Liverpool Hospital, Sydney, NSW, Australia
  9. Bankstown-Lidcombe Hospital, Sydney, NSW, Australia
  10. Blacktown Hospital, Sydney, NSW, Australia
  11. Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
  12. TOBOGM, consortium

Aim: This study assessed the prevalence of Gestational Diabetes Mellitus (GDM) at booking and its association with age, body mass index (BMI), and ethnicity among at-risk women enrolled in the Treatment of Booking Gestational Diabetes Mellitus (TOBOGM) study.

Methods: Pregnant women with risk factors for hyperglycemia in pregnancy were enrolled at booking (<20 weeks gestation) between June 2017 and May 2018. “GDM” and diabetes in pregnancy (DIP) were diagnosed using the criteria for GDM at 24-28 weeks gestation in the ADIPS 2014 guidelines. “GDM” women were further stratified into low band (fasting 5.1–5.2mmol/L, 1 hour 10.0–10.5mmol/L, 2 hours 8.5–8.9mmol/L), high band (fasting 5.3–6.0mmol/L, 1 hour ≥10.6mmol/L, 2 hours 9.0–11.0mmol/L), and high fasting glucose (HFG) (fasting 6.1-6.9mmol/l) groups based on the IADPSG odds ratios (ORs) of 1.75 and 2.0 for pregnancy complications of GDM diagnosed at 24-28 weeks gestation.

Results: In 638 pregnant women tested, the prevalence of “GDM” at booking was 24.1%. Among those diagnosed with “GDM”, 40.3% were in the low band and 59.7% were in the high band. The prevalence of DIP was 0.6%, with a further 0.6% with HFG. Compared with ‘normal’ women, women with “GDM” were older (p<0.001), heavier (p<0.001) and of non-European descent (p=0.037). GDM low- and high-band groups were similar except for their mean maternal age (30.6 ± 4.9 vs. 32.5 ± 4.1 years, p=0.011). The ORs for “GDM” development were higher in women older than 35 years (OR 3.97 [1.91–8.24]), BMI ≥35kg/m2 (OR 2.42 [1.46–4.02]) and of non-European descent (OR 1.60 [1.10–2.34]) compared with the young, normal weight, European descent reference group.

Conclusion: Preliminary results indicate that the prevalence of booking “GDM” is high among women at increased risk. The association between traditional risk factors and early “GDM” is high in the TOBOGM cohort.