RT Journal Article
SR Electronic
T1 Causes and consequences of gestational diabetes in South Asians living in Canada: results from a prospective cohort study
JF CMAJ Open
FD Canadian Medical Association
SP E604
OP E611
DO 10.9778/cmajo.20170027
VO 5
IS 3
A1 Sonia S. Anand
A1 Milan Gupta
A1 Koon K. Teo
A1 Karleen M. Schulze
A1 Dipika Desai
A1 Nora Abdalla
A1 Michael Zulyniak
A1 Russell de Souza
A1 Gita Wahi
A1 Mateen Shaikh
A1 Joseph Beyene
A1 Eileen de Villa
A1 Katherine Morrison
A1 Sarah D. McDonald
A1 Hertzel Gerstein
A1 for the South Asian Birth Cohort (START) - Canada Investigators
YR 2017
UL http://www.cmajopen.ca/content/5/3/E604.abstract
AB Background: The reasons for the increased risk of gestational diabetes among South Asian women are not well understood. We sought to identify the determinants of gestational diabetes and its impact on newborn health in a prospective birth cohort of South Asian women and their babies.Methods: As part of the South Asian Birth Cohort (START) prospective birth cohort study in Ontario, we recruited 1012 South Asian women with singleton pregnancies in the second trimester of pregnancy between July 11, 2011, and Nov. 10, 2015. We collected health information and physical measurements and administered an oral glucose tolerance test. Birth weight and skinfold thickness measurements were obtained from their newborns, and cord blood glucose and insulin levels were measured.Results: The incidence of gestational diabetes was 36.3% (95% confidence interval [CI] 33.3%-39.3%); the age-standardized rate was 40.7%. Factors associated with gestational diabetes included maternal age (odds ratio [OR] 1.08 [95% CI 1.04-1.12]), family history of diabetes (OR 1.65 [95% CI 1.26-2.17]), prepregnancy weight (OR 1.025 [95% CI 1.01-1.04]) and low diet quality (OR 1.57 [95% CI 1.16-2.12]). Maternal height was protective against gestational diabetes (OR 0.97 [95% CI 0.95-0.99]). The population attributable risk due to prepregnancy body mass index and low diet quality was 37.3%. Compared to newborns of women without gestational diabetes, those of women with gestational diabetes had a significantly higher birth weight (3267 [standard error (SE) 23] g v. 3181 [SE 17] g, p = 0.005), greater skinfold thickness (11.7 [SE 0.1] mm v. 11.2 [SE 0.1] mm, p = 0.007) and lower insulin sensitivity (glucose/insulin ratio 0.092 [SE 0.009] mmol/pmol v. 0.129 [SE 0.006] mmol/pmol, p = 0.001).Interpretation: The modifiable risk factors of prepregnancy weight and low diet quality accounted for 37% of the population attributable risk of gestational diabetes in our cohort. Intervention studies to lower prepregnancy weight and to prevent gestational diabetes among South Asian women in high-income countries are needed.