The metabolic syndrome in early pregnancy and risk of gestational diabetes mellitus

Aim: The objective of the present study was to determine whether or not maternal metabolic syndrome in early pregnancy in women without previous diabetes is associated with the development of gestational diabetes mellitus (GDM). Methods: A total of 508 women from the Rhea study-involving a pregnant cohort in Crete, Greece (2007-2009)-with singleton pregnancies were included in the present analysis. Maternal fasting serum samples were collected and blood pressure measured before gestational week 15. The metabolic syndrome in early pregnancy was defined according to NHLBI/AHA criteria. Pregnant women were screened for GDM between weeks 24 and 28 of gestation, as defined by Carpenter and Coustan criteria. Multivariable log-binomial regression models were used to estimate the effect of the metabolic syndrome in early pregnancy on the risk of GDM, after adjusting for confounding factors. Results: Women with the metabolic syndrome were at high risk of GDM (RR = 3.17; 95% CI: 1.06-9.50). Among the components of the metabolic syndrome, the most significant risk factors were impaired fasting glucose (RR = 4.92; 95% CI: 1.41-17.23) and pre-pregnancy obesity (RR = 2.65; 95% CI: 1.23-5.70). A 10-mmHg rise in systolic and diastolic blood pressure increased the relative risk of GDM by 49% (RR = 1.49; 95% CI: 1.10-2.02) and 34% (RR = 1.34; 95% CI: 1.04-1.73), respectively, whereas a 1-unit increase in pre-pregnancy BMI increased the relative risk of GDM by 6% (RR = 1.06; 95% CI: 1.01-1.12). Conclusion: These findings suggest that women with the metabolic syndrome in early pregnancy have a greater risk of developing GDM.