Maternal visceral adipose tissue during the first half of pregnancy predicts gestational diabetes at the time of delivery - a cohort study
Gestational diabetes mellitus (GDM) is a common condition, often associated with high maternal and fetal morbidity. The use of new tools for early GDM screening can contribute to metabolic control to reduce maternal and fetal risk. This study aimed to ascertain whether maternal visceral adipose tiss...
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| creator | Rocha, Alexandre da Silva Bernardi, Juliana Rombaldi Matos, Salete Kretzer, Daniela Cortés Schöffel, Alice Carvalhal Goldani, Marcelo Zubaran de Azevedo Magalhães, José Antônio |
| description | Gestational diabetes mellitus (GDM) is a common condition, often associated with high maternal and fetal morbidity. The use of new tools for early GDM screening can contribute to metabolic control to reduce maternal and fetal risk. This study aimed to ascertain whether maternal visceral adipose tissue (VAT) measurement by ultrasound during the first half of pregnancy can predict the occurrence of GDM during the third trimester.
A prospective cohort study of 133 pregnant women with gestational age ≤20 weeks in an outpatient setting. VAT depth was measured by ultrasound at the maternal periumbilical region. GDM status was obtained through hospital charts during hospitalization to delivery. A Receiver Operator Characteristic (ROC) curve was used to determine the optimum threshold to predict GDM.
According to the ROC curve, a 45mm threshold was identified as the best cut-off value, with 66% of accuracy to predict GDM. Crude and adjusted odds ratios (OR) for GDM were 13.4 (95%CI 2.9-61.1) and 8.9 (95%CI 1.9-42.2), respectively. A similar result was obtained among pre-gravid non-obese women, with crude and adjusted OR of 16.6 (95%CI 1.9-142.6) and 14.4 (95%CI 1.7-125.7), respectively. Among pre-gravid obese patients, a 45mm threshold did not reach statistical significance to predict GDM.
The high and significant OR found before and after adjustments provides additional evidence of a strong association between VAT and GDM. It appears that VAT measurement during the first half of pregnancy has great potential in identifying non-obese women at high risk for GDM. This evidence can assist obstetricians in correctly allocating resources among populations of pregnant women at risk, determined not only by pre-gravid body mass index (BMI). |
| doi_str_mv | 10.1371/journal.pone.0232155 |
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A prospective cohort study of 133 pregnant women with gestational age ≤20 weeks in an outpatient setting. VAT depth was measured by ultrasound at the maternal periumbilical region. GDM status was obtained through hospital charts during hospitalization to delivery. A Receiver Operator Characteristic (ROC) curve was used to determine the optimum threshold to predict GDM.
According to the ROC curve, a 45mm threshold was identified as the best cut-off value, with 66% of accuracy to predict GDM. Crude and adjusted odds ratios (OR) for GDM were 13.4 (95%CI 2.9-61.1) and 8.9 (95%CI 1.9-42.2), respectively. A similar result was obtained among pre-gravid non-obese women, with crude and adjusted OR of 16.6 (95%CI 1.9-142.6) and 14.4 (95%CI 1.7-125.7), respectively. Among pre-gravid obese patients, a 45mm threshold did not reach statistical significance to predict GDM.
The high and significant OR found before and after adjustments provides additional evidence of a strong association between VAT and GDM. It appears that VAT measurement during the first half of pregnancy has great potential in identifying non-obese women at high risk for GDM. This evidence can assist obstetricians in correctly allocating resources among populations of pregnant women at risk, determined not only by pre-gravid body mass index (BMI).</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0232155</identifier><identifier>PMID: 32353068</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adipose tissue ; Age ; Biology and Life Sciences ; Body fat ; Body mass ; Body mass index ; Body size ; Cardiovascular disease ; Cohort analysis ; Diabetes ; Diabetes mellitus ; Fetuses ; Gestational age ; Gestational diabetes ; Glucose ; Health risk assessment ; Hospitals ; Hyperglycemia ; Insulin resistance ; Medicine ; Medicine and Health Sciences ; Metabolism ; Morbidity ; Obesity ; Preeclampsia ; Pregnancy ; Public health ; Research and Analysis Methods ; Risk ; Ultrasonic imaging ; Ultrasound ; Womens health</subject><ispartof>PloS one, 2020-04, Vol.15 (4), p.e0232155-e0232155</ispartof><rights>2020 Rocha et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Rocha et al 2020 Rocha et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c526t-2740193ac3e4a528de01996ae723662e51ff7159cb274ecebc500790b455cf0f3</citedby><cites>FETCH-LOGICAL-c526t-2740193ac3e4a528de01996ae723662e51ff7159cb274ecebc500790b455cf0f3</cites><orcidid>0000-0002-9283-0559</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7192370/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7192370/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,2096,2915,23847,27905,27906,53772,53774,79349,79350</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32353068$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Petry, Clive J.</contributor><creatorcontrib>Rocha, Alexandre da Silva</creatorcontrib><creatorcontrib>Bernardi, Juliana Rombaldi</creatorcontrib><creatorcontrib>Matos, Salete</creatorcontrib><creatorcontrib>Kretzer, Daniela Cortés</creatorcontrib><creatorcontrib>Schöffel, Alice Carvalhal</creatorcontrib><creatorcontrib>Goldani, Marcelo Zubaran</creatorcontrib><creatorcontrib>de Azevedo Magalhães, José Antônio</creatorcontrib><title>Maternal visceral adipose tissue during the first half of pregnancy predicts gestational diabetes at the time of delivery - a cohort study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Gestational diabetes mellitus (GDM) is a common condition, often associated with high maternal and fetal morbidity. The use of new tools for early GDM screening can contribute to metabolic control to reduce maternal and fetal risk. This study aimed to ascertain whether maternal visceral adipose tissue (VAT) measurement by ultrasound during the first half of pregnancy can predict the occurrence of GDM during the third trimester.
A prospective cohort study of 133 pregnant women with gestational age ≤20 weeks in an outpatient setting. VAT depth was measured by ultrasound at the maternal periumbilical region. GDM status was obtained through hospital charts during hospitalization to delivery. A Receiver Operator Characteristic (ROC) curve was used to determine the optimum threshold to predict GDM.
According to the ROC curve, a 45mm threshold was identified as the best cut-off value, with 66% of accuracy to predict GDM. Crude and adjusted odds ratios (OR) for GDM were 13.4 (95%CI 2.9-61.1) and 8.9 (95%CI 1.9-42.2), respectively. A similar result was obtained among pre-gravid non-obese women, with crude and adjusted OR of 16.6 (95%CI 1.9-142.6) and 14.4 (95%CI 1.7-125.7), respectively. Among pre-gravid obese patients, a 45mm threshold did not reach statistical significance to predict GDM.
The high and significant OR found before and after adjustments provides additional evidence of a strong association between VAT and GDM. It appears that VAT measurement during the first half of pregnancy has great potential in identifying non-obese women at high risk for GDM. 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a cohort study</title><author>Rocha, Alexandre da Silva ; Bernardi, Juliana Rombaldi ; Matos, Salete ; Kretzer, Daniela Cortés ; Schöffel, Alice Carvalhal ; Goldani, Marcelo Zubaran ; de Azevedo Magalhães, José Antônio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c526t-2740193ac3e4a528de01996ae723662e51ff7159cb274ecebc500790b455cf0f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adipose tissue</topic><topic>Age</topic><topic>Biology and Life Sciences</topic><topic>Body fat</topic><topic>Body mass</topic><topic>Body mass index</topic><topic>Body size</topic><topic>Cardiovascular disease</topic><topic>Cohort analysis</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Fetuses</topic><topic>Gestational age</topic><topic>Gestational diabetes</topic><topic>Glucose</topic><topic>Health risk assessment</topic><topic>Hospitals</topic><topic>Hyperglycemia</topic><topic>Insulin resistance</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Metabolism</topic><topic>Morbidity</topic><topic>Obesity</topic><topic>Preeclampsia</topic><topic>Pregnancy</topic><topic>Public health</topic><topic>Research and Analysis Methods</topic><topic>Risk</topic><topic>Ultrasonic imaging</topic><topic>Ultrasound</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rocha, Alexandre da Silva</creatorcontrib><creatorcontrib>Bernardi, Juliana Rombaldi</creatorcontrib><creatorcontrib>Matos, Salete</creatorcontrib><creatorcontrib>Kretzer, Daniela Cortés</creatorcontrib><creatorcontrib>Schöffel, Alice Carvalhal</creatorcontrib><creatorcontrib>Goldani, Marcelo Zubaran</creatorcontrib><creatorcontrib>de Azevedo Magalhães, José Antônio</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rocha, Alexandre da Silva</au><au>Bernardi, Juliana Rombaldi</au><au>Matos, Salete</au><au>Kretzer, Daniela Cortés</au><au>Schöffel, Alice Carvalhal</au><au>Goldani, Marcelo Zubaran</au><au>de Azevedo Magalhães, José Antônio</au><au>Petry, Clive J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Maternal visceral adipose tissue during the first half of pregnancy predicts gestational diabetes at the time of delivery - a cohort study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2020-04-30</date><risdate>2020</risdate><volume>15</volume><issue>4</issue><spage>e0232155</spage><epage>e0232155</epage><pages>e0232155-e0232155</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Gestational diabetes mellitus (GDM) is a common condition, often associated with high maternal and fetal morbidity. The use of new tools for early GDM screening can contribute to metabolic control to reduce maternal and fetal risk. This study aimed to ascertain whether maternal visceral adipose tissue (VAT) measurement by ultrasound during the first half of pregnancy can predict the occurrence of GDM during the third trimester.
A prospective cohort study of 133 pregnant women with gestational age ≤20 weeks in an outpatient setting. VAT depth was measured by ultrasound at the maternal periumbilical region. GDM status was obtained through hospital charts during hospitalization to delivery. A Receiver Operator Characteristic (ROC) curve was used to determine the optimum threshold to predict GDM.
According to the ROC curve, a 45mm threshold was identified as the best cut-off value, with 66% of accuracy to predict GDM. Crude and adjusted odds ratios (OR) for GDM were 13.4 (95%CI 2.9-61.1) and 8.9 (95%CI 1.9-42.2), respectively. A similar result was obtained among pre-gravid non-obese women, with crude and adjusted OR of 16.6 (95%CI 1.9-142.6) and 14.4 (95%CI 1.7-125.7), respectively. Among pre-gravid obese patients, a 45mm threshold did not reach statistical significance to predict GDM.
The high and significant OR found before and after adjustments provides additional evidence of a strong association between VAT and GDM. It appears that VAT measurement during the first half of pregnancy has great potential in identifying non-obese women at high risk for GDM. This evidence can assist obstetricians in correctly allocating resources among populations of pregnant women at risk, determined not only by pre-gravid body mass index (BMI).</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>32353068</pmid><doi>10.1371/journal.pone.0232155</doi><orcidid>https://orcid.org/0000-0002-9283-0559</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adipose tissue Age Biology and Life Sciences Body fat Body mass Body mass index Body size Cardiovascular disease Cohort analysis Diabetes Diabetes mellitus Fetuses Gestational age Gestational diabetes Glucose Health risk assessment Hospitals Hyperglycemia Insulin resistance Medicine Medicine and Health Sciences Metabolism Morbidity Obesity Preeclampsia Pregnancy Public health Research and Analysis Methods Risk Ultrasonic imaging Ultrasound Womens health |
| title | Maternal visceral adipose tissue during the first half of pregnancy predicts gestational diabetes at the time of delivery - a cohort study |
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