The roles of maternal characteristics and early-pregnancy serum parameters in gestational diabetes: The Finnish Gestational Diabetes study

Thesis event information

Date and time of the thesis defence

Place of the thesis defence

Oulu University Hospital, auditorium 4

Topic of the dissertation

The roles of maternal characteristics and early-pregnancy serum parameters in gestational diabetes: The Finnish Gestational Diabetes study

Doctoral candidate

Licentiate of Medicine Sanna Mustaniemi

Faculty and unit

University of Oulu Graduate School, Faculty of Medicine, Research Unit of Clinical Medicine

Subject of study

Medicine, Obstetrics and Gynecology

Opponent

Docent Eeva Ekholm, Obstetrics and Gynecology, Turku University Hospital

Custos

Professor Marja Vääräsmäki, University of Oulu; Obstetrics and Gynecology, Oulu University Hospital

Visit thesis event

Add event to calendar

The roles of maternal characteristics and early-pregnancy serum parameters in gestational diabetes: the Finnish Gestational Diabetes study

Gestational diabetes (GDM) is defined as hyperglycaemia with onset or first recognition in pregnancy, affecting one of fifth of pregnancies in Finland. Besides its adverse perinatal outcomes, it predisposes both mother and child to long-term morbidity, such as type 2 diabetes, metabolic syndrome and cardiovascular disease.

The major clinical risk factors for GDM, such as pre-pregnancy overweight and obesity, an advanced age and a family history of diabetes, are well established. However, the roles of other maternal clinical characteristics, such as polycystic ovary syndrome (PCOS), in the risk of developing GDM are controversial. The effect of an adequate gestational weight gain (GWG) on the prevention of fetal overgrowth also remain unclear. In addition to clinical risk factors, early-pregnancy serum parameters involved in the underlying pathophysiological mechanisms of GDM could improve the early detection of women with a high risk of GDM.

The aim of this study was to evaluate the roles of maternal characteristics, especially PCOS and GWG, and serum parameters measured in early pregnancy, such as sex hormone-binding globulin (SHBG) and androgen excess, as well as of traditional lipids and ceramides (Cer), with subsequent GDM. The study was based on the Finnish Gestational Diabetes study, which included 1,146 women with GDM and 1,066 non-diabetic controls.

The prevalence of PCOS was higher among women with GDM than in controls (10.7% vs. 7.4%), but PCOS was not an independent risk factor for GDM after considering pre-pregnancy BMI and age. Moderate GWG was an important factor in protecting against fetal overgrowth, especially in women with GDM and obesity.

Lower early-pregnancy SHBG levels were associated with early-onset GDM, fasting hyperglycaemia and the need for insulin therapy, whereas androgen excess was associated with slightly higher post-prandial glucose values. Thus, low SHBG levels might reflect chronic insulin resistance, while androgen excess might impair post-prandial insulin secretion. Of the lipids measured in early pregnancy, higher levels of triglycerides, LDL and Cer(d18:1/24:0) were independent predictors of GDM. Along with clinical risk factors and triglycerides, ceramides did not markedly improve the prediction of GDM. Adverse alterations in hormonal and lipid parameters highlight the clustering of metabolic risk factors involved in GDM.
Last updated: 12.9.2023