Are short women at risk for gestational diabetes mellitus?

Objective: The aim of the study was to assess the influence of height variations on the risk of gestational diabetes mellitus (GDM). Research design and methods: We analyzed the medical records of 1830 Caucasian women with GDM and 1011 healthy pregnant women. The following data were collected: age, prior macrosomia, prior GDM, parity, history of type 2 diabetes in first-degree relatives, weight before pregnancy, weight gain during pregnancy, glucose level at the first obstetric visit, results of the glucose challenge test and oral glucose tolerance test (OGTT), HbA1c, and method for treatment of GDM. Results: Women with GDM were significantly shorter than the healthy controls (165.7+/-5.6 vs 163.8+/-6.6 cm; P<0.001). The differences in height were not significant between GDM women who required insulin therapy and those treated with diet alone (P=0.12). All the studied variables, including height, were independently associated with GDM. Even after adjustment for confounding variables, height was still associated with GDM (odds ratio 0.958, 95% confidence interval: 0.94-0.97; P<0.00001). In women with GDM diagnosed by 75-g OGTT, we found a significant inverse association of height adjusted for age and pregravid weight with 2-h glucose level (beta=-0.12; P<0.0001). Conclusions: Caucasian women with GDM are shorter than pregnant women without GDM regardless of the diagnostic criteria used or the severity of glucose intolerance. Although height is an independent predictor for GDM, its predictive value for identifying women at risk is relatively low and should not be considered in selective screening for this disease.