SEARCHCOHORTobstetrics and gynecology, endocrinology

cohort·obstetrics and gynecology, endocrinology, nutrition, epidemiology, public health·PMC10035259

Joint effect of maternal pre-pregnancy body mass index and folic acid supplements on gestational diabetes mellitus risk: a prospective cohort study

BMC Pregnancy and Childbirth · 9 authors, 4 centres

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TL;DR

This prospective cohort study recruited 3,186 pregnant women at 4 to 14 weeks of gestation in Qingdao between May 2019 and June 2021, with 2,095 included after exclusions.

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This prospective cohort study recruited 3,186 pregnant women at 4 to 14 weeks of gestation in Qingdao between May 2019 and June 2021, with 2,095 included after exclusions. GDM was diagnosed at 24–28 weeks using a 75 g 2-hour OGTT, and incident GDM occurred in 17.76% of participants.

STUDY TYPE

cohort

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obstetrics and gynecology

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AI pipeline

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ORIGINAL PAPER

PMC10035259

Joint effect of maternal pre-pregnancy body mass index and folic acid supplements on gestational diabetes mellitus risk: a prospective cohort study

BMC Pregnancy and Childbirth

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ABSTRACT

Abstract Background The joint effect of folic acid (FA) supplements and maternal pre-pregnancy body mass index (BMI) on gestational diabetes mellitus (GDM) has not been fully addressed. This study aimed to examine the joint effect of FA supplements and pre-pregnancy BMI on GDM. Methods Pregnant women at 4 to 14 weeks of gestation (n = 3186) were recruited during their first prenatal visit in Qingdao from May 1, 2019, to June 27, 2021. The main outcome was GDM at 24–28 weeks’ gestation. Screening was based on 75 g 2-hour oral glucose tolerance (OGTT), a fasting glucose ≥ 5.1 mmol/L, or a 1-hour result ≥ 10.0 mmol/L, or a 2-hour result ≥ 8.5 mmol/L. The interactive effect of FA supplements and pre-pregnancy BMI on GDM was examined using logistic regression analysis and ratio of odds ratios (ROR) was used to compare subgroup differences. Results Overall, 2,095 pregnant women were included in the analysis, and GDM incidence was 17.76%. Compared with women with pre-pregnancy BMI lower than 25.0 kg/m 2 and FA-Sufficient supplements ≥ 400 µg/day (FA-S) population, the adjusted odds ratios (aORs) of FA-S and FA-Deficiency supplements < 400 µg/d (FA-D) were 3.57 (95% confidence interval [CI]: 2.02–6.34) and 10.82 (95% CI: 1.69–69.45) for the obese women (BMI ≥ 30.0 kg/m 2 ), and the aORs of FA-S and FA-D were 2.17 (95% CI: 1.60–2.95) and 3.27 (95% CI: 1.55–6.92) for overweight women (25.0 kg/m 2 ≤ BMI < 30.0 kg/m 2 ). However, the risk of GDM did not differ significantly between the FA-D and the FA-S group in pre-pregnancy obese women (ROR = 2.70, 95%CI: 0.47–2.30), or overweight women (ROR = 0.66, 95%CI: 0.30–1.49). After further stratification of FA supplementation time, F-D and FA-S in obese women showed an interaction when FA supplement intake time < 3 months. However, there was no significant difference between subgroups (ROR = 1.63, 95% CI: 0.37–7.04). Conclusion Maternal pre-pregnancy BMI was associated with the incidence of GDM, the dose of FA supplementation from pre-pregnancy to early pregnancy was not found to be related to the incidence of GDM. The dosage of FA supplement was not associated with GDM irrespective of maternal pre-pregnancy BMI. Keywords: Pre-pregnancy body Mass Index, Folic acid supplements, Gestational diabetes Mellitus, Interaction

CITATION EXPORT

Minyu Li, Lijiang Wang, Zhanhui Du et al.. Joint effect of maternal pre-pregnancy body mass index and folic acid supplements on gestational diabetes mellitus risk: a prospective cohort study. BMC Pregnancy and Childbirth. (2023). https://doi.org/10.1186/s12884-023-05510-y

AUTHORS

9 · 4 CENTRES

Minyu Li, Lijiang Wang, Zhanhui Du, Qianqian Shen, Lu Jiang, Lun Sui, Nan Zhang, Hong Wang, Guoju Li

1Public Health School, Medical College of Qingdao University, Qingdao, Shandong Province P.R. China
2Qingdao Women and Children’s Hospital, Qingdao University, Qingdao City, Shandong Province P.R. China
3School of Public Health, Peking university, Beijing, 100191 China
4Qingdao Women and Children’s Hospital, Qingdao University, No.6 Tongfu Road, Qingdao, 266000 China