Journal
GYNECOLOGICAL ENDOCRINOLOGY
Volume 30, Issue 11, Pages 840-844Publisher
TAYLOR & FRANCIS LTD
DOI: 10.3109/09513590.2014.937336
Keywords
Birth weight; diabetes; fetal growth retardation; gestational; waist circumference
Funding
- Academy of Finland [117797, 126925, 121584]
- Social Insurance Institution of Finland
- Turku University Foundation
- special federal grants for Turku University Central Hospital
- Juho Vainio Foundation
- Finnish Foundation of Cardiovascular Research
- Finnish Cultural Foundation
- Orion Farmos Research Foundation
- Academy of Finland (AKA) [117797, 117797] Funding Source: Academy of Finland (AKA)
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Pregnancy conditions such as gestational diabetes (GDM) and macrosomia lead to an increased risk of diabetes and cardiovascular disease in the offspring, perpetuating a cycle of poor health. We hypothesized that (1) pre-pregnancy indicators of metabolism would be associated with GDM and birthweight; and (2) the lipid accumulation product (LAP; incorporating waist circumference and triglycerides) and visceral adiposity index (VAI; incorporating waist circumference, triglycerides, and HDL-c) would be better predictors of GDM and birthweight than other indicators. Data from the Cardiovascular Risk in Young Finns Study were linked to the Finnish birth registry for 349 women. BMI, triglycerides, waist circumference, insulin, HOMA-IR, LAP, and VAI at the visit prior to the pregnancy were examined as predictors of GDM and large-for-gestational-age (LGA) using logistic regression with adjustment for age, parity, and smoking. Waist circumference was the strongest predictor of GDM (adjusted odds ratio [aOR] 1.66, 95% confidence interval 1.16-2.38) and LGA (aOR 1.41, 1.00-1.99). For GDM, all markers had similar discrimination; for LGA, the area under the receiver operating curve for waist circumference was significantly higher than for BMI (p < 0.01). This analysis suggests that pregnancy and even offspring health is affected by risk factors outside the immediate time period of pregnancy.
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