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  • 251.
    Östlund, Ingrid
    et al.
    Örebro University, Department of Clinical Medicine.
    Haglund, Bengt
    Hanson, Ulf
    Gestational diabetes and preeclampsia2004In: European Journal of Obstetrics, Gynecology, and Reproductive Biology, ISSN 0301-2115, E-ISSN 1872-7654, Vol. 113, no 1, p. 12-16Article in journal (Refereed)
    Abstract [en]

    Objective: To determine whether gestational diabetes mellitus (GDM) increases the risk for preeclampsia independent of other risk factors. Study design: The association between GDM and preeclampsia was analyzed in a population of women who had given birth to singletons registered in Swedish Medical Birth Register from 1992 through 1996 (n=430,852). Results: GDM occurred in 0.8% and preeclampsia in 2.9% of all pregnancies. The rate of preeclampsia was higher in the GDM than in the non-GDM group (6.1% versus 2.8%). High age, nullipara, chronic hypertension, kidney disease, and high body mass index (BMI) were all independently associated with increased risk for preeclampsia. Smoking was associated with decreased risk. Adjusted odds ratio for GDM as a risk factor for preeclampsia was 1.61 (95% confidence interval (CI) 1.39–1.86) when prepregnancy BMI, which was a true confounder, was included in the last step of the multiple logistic regression analysis. Conclusions: There is an independent and significant association between GDM and preeclampsia. Obesity is a major confounding factor but could not explain the total excess risk.

  • 252.
    Östlund, Ingrid
    et al.
    Örebro University, Department of Clinical Medicine.
    Hanson, Ulf
    Occurrence of gestational diabetes mellitus and the value of different screening indicators for the oral glucose tolerance test2003In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 82, no 2, p. 103-108Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    The objective of the present study was to determine prevalence of gestational diabetes mellitus (GDM) in terms of impaired glucose tolerance (IGT) and diabetes mellitus (DM), and the value of traditional anamnestic risk factors for predicting outcome of the oral glucose tolerance test (OGTT).

    METHODS:

    A prospective population-based study in a defined geographic area in Sweden. All pregnant nondiabetic women (n = 4918) attending maternal health care from July 1994 to June 1996 were offered a 75g OGTT in gestational weeks 28-32. Traditional anamnestic risk factors, as well as results of the OGTT in terms of fasting-B-glucose and 2h-B-glucose, were registered.

    RESULTS:

    3616 (73.5%) women agreed to perform the OGTT. Sixty-one (1.7%) of those had GDM [47 (1.3%) had impaired glucose tolerance and 14 (0.4%) had diabetes mellitus]. 15.8% fulfilled traditional risk factor criteria. Traditional anamnestic risk factors as an indicator to perform an OGTT identified 29/61 GDM women and 9/14 women with DM. Among primiparas, 4/21 with gestational diabetes mellitus were detected.

    CONCLUSION:

    Using traditional risk factors as an indicator to perform an OGTT gives a low sensitivity to detect GDM and even DM especially among primiparas.

  • 253.
    Östlund, Ingrid
    et al.
    Örebro University, Department of Clinical Medicine.
    Hanson, Ulf
    Repeated random blood glucose measurements as universal screening test for gestational diabetes mellitus2004In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 83, no 1, p. 46-51Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    To determine the value of repeated random blood glucose (R-B-glucose) measurements alone or in combination with traditional risk factors [family history of diabetes, obesity, prior large-for-gestational-age (LGA) infant or prior gestational diabetes mellitus (GDM)] to predict the outcome of the oral glucose tolerance test (OGTT).

    METHODS:

    A prospective population-based study was undertaken in a Swedish county. All pregnant nondiabetic women (n = 4918) visiting the maternal health care clinics over a 2-year period were offered a 75-g OGTT in gestational weeks 28-32. Traditional risk factors and values of repeated R-B-glucose measurements were registered, as well as the results of the OGTT, in terms of fasting B-glucose and 2-h B-glucose.

    RESULTS:

    A total of 3616 women (73.5%) had an OGTT. Of these, 1.7% had GDM, 1.3% impaired glucose tolerance (IGT) and 0.4% diabetes mellitus (DM). An R-B-glucose cut-off level > or =8.0 mmol/L as the only indicator for an OGTT was optimal for detecting GDM with regard to sensitivity (47.5%) and specificity (97.0%). It has the same sensitivity for detecting GDM as using traditional risk factors, but reduces the need to carry out the OGTT from 15.8% to 3.8% of the population. Combined with prior LGA infant or prior GDM as indications for the OGTT in the present study, all women with DM and 44.7% of those with IGT will be identified. Only 7.3% of the population will have to take the OGTT.

    CONCLUSION:

    A random B-glucose level > or = 8.0 mmol/L prior LGA infant or prior GDM as an indicator for taking the OGTT is a simple and effective first step in a two-step screening model for GDM.

  • 254.
    Östlund, Ingrid
    et al.
    Örebro University, Department of Clinical Medicine.
    Hanson, Ulf
    Björklund, Anders
    Hjertberg, Ragnhild
    Eva, Nord
    Nordlander, Elisabeth
    Swahn, Marja-Liisa
    Wager, Jan
    Maternal and fetal outcomes if gestational impaired glucose tolerance is not treated2003In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, Vol. 26, no 7, p. 2107-2111Article in journal (Refereed)
3456 251 - 254 of 254
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