Maternal, Behavioral, and Environmental Risk Factors for Gestational Diabetes and Preterm Birth Among Pregnant Women

Background: Lifestyle changed in Kuwait with the rapid development and economic expansion and the Americanization of the Kuwaiti market. Fast food and sedentary lifestyle became very prevalent. Environmental exposures such as passive tobacco smoke and extreme temperatures are common in Kuwait where the prevalence of chronic conditions is increasing. We describe a Kuwait based pregnancy-birth cohort and examine the associations between perinatal exposures and the risk of chronic disease. Methods: We recruited women from antenatal clinics in Kuwait and administered baseline questionnaires then followed the women postnatally. We examined maternal and lifestyle risk factors of gestational diabetes mellitus (GDM). We examined the association between passive tobacco smoke exposure and gestational diabetes, and finally we examined the association between preterm delivery with heat and humidity in Kuwait Results: We successfully enrolled 2,478 women and followed 2,254 to delivery. Overall, frequencies of stillbirth, preterm birth, and small for gestational age were comparable to other developed countries. The incidence of self-reported gestational diabetes was within the expected range worldwide. After past GDM history, pre-pregnancy obesity was the strongest maternal risk factor associated with GDM. We observed patterns suggestive of a positive association between home passive tobacco smoke exposure and GDM among primiparous women. Finally, high relative humidity but not temperature was associated with an increased risk of preterm delivery. Conclusions: We successfully established a large pregnancy birth cohort in Kuwait. There are several social and environmental challenges in Kuwait that may increase the risk of chronic disease such as diabetes, which is already very prevalent in Kuwait. Our results should be replicated and the results used to inform interventions to reduce the rates of chronic disease in Kuwait. Perinatal; Cohort; Environmental Exposure; Gestational Diabetes; Preterm Birth; Extreme Weather; Kuwait