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Open Access Highly Accessed Research article

Increased incidence of glucose disorders during pregnancy is not explained by pre-pregnancy obesity in London, Canada

Margie H Davenport1, M Karen Campbell2345 and Michelle F Mottola156*

Author Affiliations

1 R. Samuel McLaughlin Foundation Exercise and Pregnancy Lab, School of Kinesiology, The University of Western Ontario, London, Ontario, N6A 3K7, Canada

2 Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Ontario, N6A 3K7, Canada

3 Department of Obstetrics and Gynecology, The University of Western Ontario, London, Ontario, N6A 3K7, Canada

4 Department of Paediatrics, The University of Western Ontario, London, Ontario, N6A 3K7, Canada

5 Childrens Health Research Institute, The University of Western Ontario, London, Ontario, N6A 3K7, Canada

6 Department of Anatomy and Cell Biology, The University of Western Ontario, London, Ontario, N6A 3K7, Canada

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BMC Pregnancy and Childbirth 2010, 10:85  doi:10.1186/1471-2393-10-85

Published: 24 December 2010

Abstract

Background

The increasing incidence of impaired glucose tolerance (IGT), gestational diabetes (GDM) and type 2 diabetes (T2D) during pregnancy was hypothesized to be associated with increases in pre-pregnancy body mass index (BMI). The aims were to 1) determine the prevalence of IGT/GDM/T2 D over a 10 year period; 2) examine the relationship between maternal overweight/obesity and IGT/GDM/T2D; and 3) examine the extent to which maternal metabolic complications impact maternal and fetal pregnancy outcomes.

Methods

Data arose from a perinatal database which contains maternal characteristics and perinatal outcome for all singleton infants born in London, Canada between January 1, 2000 and December 31, 2009. Univariable and multivariable odds ratios (OR) were estimated using logistic regression with IGT/GDM/T2 D being the outcome of interest.

Results

A total of 36,597 women were included in the analyses. Population incidence of IGT, GDM and T2 D rose from 0.7%, 2.9% and 0.5% in 2000 to 1.2%, 4.2% and 0.9% in 2009. The univariable OR for IGT, GDM and T2 D were 1.65, 1.52 and 2.06, respectively, over the ten year period. After controlling for maternal age, parity and pre-pregnancy BMI the OR did not decrease. Although there was a positive relationship between pre-pregnancy BMI and prevalence of IGT/GDM/T2 D, this did not explain the time trends in the latter. Diagnosis of IGT/GDM/T2 D increased the risk of having an Apgar score <7 at 5 minutes, which was partially explained by gestational hypertension, high placental ratio, gestational age and large for gestational age babies.

Conclusions

We found a significant increase in the incidence of IGT/GDM/T2 D for the decade between 2000-2009 which was not explained by rising prevalence of maternal overweight/obesity.