Evaluation of pregnancy outcomes in women with GCK‐MODY
Aims To determine the fetal and maternal outcomes in pregnant women with Glucokinase‐Maturity onset diabetes of the young (GCK‐MODY). Methods We studied the obstetric and perinatal outcomes in 99 pregnancies of 34 women with GCK‐MODY. The mutation status of the offspring was known in 29 and presumed...
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| Veröffentlicht in: | Diabetic medicine 2021-06, Vol.38 (6), p.e14488-n/a |
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| creator | López Tinoco, Cristina Sánchez Lechuga, Begoña Bacon, Siobhan Colclough, Kevin Ng, Nicholas Wong, Eleanor Goulden, Eirena L. Edwards, Jackie Fleming, Aileen Byrne, Bridgette Byrne, Maria M. |
| description | Aims
To determine the fetal and maternal outcomes in pregnant women with Glucokinase‐Maturity onset diabetes of the young (GCK‐MODY).
Methods
We studied the obstetric and perinatal outcomes in 99 pregnancies of 34 women with GCK‐MODY. The mutation status of the offspring was known in 29 and presumed in 33. Clinical outcomes were determined and compared between affected (n = 39) and unaffected (n = 23) offspring.
Results
59% of pregnancies were treated with diet alone and 41% received insulin. Birthweight, percentage of large for gestational age (LGA) and caesarean section (CS) in GCK‐unaffected offspring was significantly higher than in GCK‐affected offspring (4.0 ± 0.7 vs. 3.4 ± 0.4 kg, p = 0.001), 15 (65%) vs. 5(13%) (p = 0.00006) and 17 (74%) vs. 11 (28%) (p = 0.001), respectively. We observed an earlier gestational age at delivery on insulin in unaffected offspring (38.3 ± 1.0 vs. 39.5 ± 1.5 weeks, p = 0.03) with no significant change in LGA (9 (82%) vs. 6 (50%); p = 0.12), and a higher rate of CS (8 [73%] vs. 3 [11%]; p |
| doi_str_mv | 10.1111/dme.14488 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2467614841</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2527736569</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3938-3f481cfd9ae49f198e00bce52d1809d582b8cb1b5242f30769213518739c23a43</originalsourceid><addsrcrecordid>eNp1kLFOwzAQhi0EoqUw8AIoEgsMaX22k9gjaktBtOoCA5OVOA6kSuISJ1TdeASekSfBkMKAxA13N3z6dPcjdAp4CK5GaamHwBjne6gPLGR-wATsoz6OGPEpjqCHjqxdYQxEUHGIepSSKIoo7iMxfY2LNm5yU3km89a1fqriSm090zbKlNp6eeVt3OJ63jx7s_Hdx9v7Yjl5PEYHWVxYfbKbA_RwPb0f3_jz5ex2fDX3FRWU-zRjHFSWilgzkYHgGuNE6YCkwLFIA04SrhJIAsJI5m4NBQEaAI-oUITGjA7QRedd1-al1baRZW6VLoq40qa1krAwCoFxBg49_4OuTFtX7jpJAvcxDYNQOOqyo1RtrK11Jtd1Xsb1VgKWX3lKl6f8ztOxZztjm5Q6_SV_AnTAqAM2eaG3_5vkZDHtlJ9VNnx_</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2527736569</pqid></control><display><type>article</type><title>Evaluation of pregnancy outcomes in women with GCK‐MODY</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>López Tinoco, Cristina ; Sánchez Lechuga, Begoña ; Bacon, Siobhan ; Colclough, Kevin ; Ng, Nicholas ; Wong, Eleanor ; Goulden, Eirena L. ; Edwards, Jackie ; Fleming, Aileen ; Byrne, Bridgette ; Byrne, Maria M.</creator><creatorcontrib>López Tinoco, Cristina ; Sánchez Lechuga, Begoña ; Bacon, Siobhan ; Colclough, Kevin ; Ng, Nicholas ; Wong, Eleanor ; Goulden, Eirena L. ; Edwards, Jackie ; Fleming, Aileen ; Byrne, Bridgette ; Byrne, Maria M.</creatorcontrib><description>Aims
To determine the fetal and maternal outcomes in pregnant women with Glucokinase‐Maturity onset diabetes of the young (GCK‐MODY).
Methods
We studied the obstetric and perinatal outcomes in 99 pregnancies of 34 women with GCK‐MODY. The mutation status of the offspring was known in 29 and presumed in 33. Clinical outcomes were determined and compared between affected (n = 39) and unaffected (n = 23) offspring.
Results
59% of pregnancies were treated with diet alone and 41% received insulin. Birthweight, percentage of large for gestational age (LGA) and caesarean section (CS) in GCK‐unaffected offspring was significantly higher than in GCK‐affected offspring (4.0 ± 0.7 vs. 3.4 ± 0.4 kg, p = 0.001), 15 (65%) vs. 5(13%) (p = 0.00006) and 17 (74%) vs. 11 (28%) (p = 0.001), respectively. We observed an earlier gestational age at delivery on insulin in unaffected offspring (38.3 ± 1.0 vs. 39.5 ± 1.5 weeks, p = 0.03) with no significant change in LGA (9 (82%) vs. 6 (50%); p = 0.12), and a higher rate of CS (8 [73%] vs. 3 [11%]; p < 0.001), and no change in small for gestational age (0 [0%] vs. 4 [14%]; p = 0.30) in affected offspring.
Conclusion
Insulin therapy in unaffected offspring did not reduce LGA and was associated with earlier gestational age at delivery. Insulin treatment in GCK‐affected offspring was associated with an increased incidence of CS, but did not adversely affect fetal outcome. Fetal genotype determines birthweight rather than treatment. Pre‐pregnancy diagnosis of GCK‐MODY, use of continuous glucose monitoring and non‐invasive fetal genotyping may enable further investigation of targeted therapy in this condition.</description><identifier>ISSN: 0742-3071</identifier><identifier>EISSN: 1464-5491</identifier><identifier>DOI: 10.1111/dme.14488</identifier><identifier>PMID: 33277730</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Adult ; Age ; Birth Weight ; Blood Glucose - metabolism ; Blood Glucose Self-Monitoring ; Clinical outcomes ; Diabetes ; Diabetes mellitus ; Diabetes Mellitus, Type 2 - blood ; Diabetes Mellitus, Type 2 - epidemiology ; Diabetes Mellitus, Type 2 - genetics ; DNA - genetics ; DNA Mutational Analysis ; Female ; Fetuses ; Follow-Up Studies ; Genotypes ; Genotyping ; Gestational Age ; Gestational diabetes ; Glucokinase ; Glucokinase - genetics ; Glucokinase - metabolism ; Glucose monitoring ; Humans ; Incidence ; Insulin ; Maternal & child health ; maturity‐onset diabetes of the young ; Mutation ; Offspring ; Pedigree ; Pregnancy ; Pregnancy in Diabetics - blood ; Pregnancy in Diabetics - epidemiology ; Pregnancy in Diabetics - genetics ; Pregnancy Outcome ; Prenatal development ; Retrospective Studies ; Small for gestational age ; Spain - epidemiology ; Womens health</subject><ispartof>Diabetic medicine, 2021-06, Vol.38 (6), p.e14488-n/a</ispartof><rights>2020 Diabetes UK</rights><rights>2020 Diabetes UK.</rights><rights>Diabetic Medicine © 2021 Diabetes UK</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3938-3f481cfd9ae49f198e00bce52d1809d582b8cb1b5242f30769213518739c23a43</citedby><cites>FETCH-LOGICAL-c3938-3f481cfd9ae49f198e00bce52d1809d582b8cb1b5242f30769213518739c23a43</cites><orcidid>0000-0002-4352-9655 ; 0000-0002-9394-8698</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fdme.14488$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fdme.14488$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33277730$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>López Tinoco, Cristina</creatorcontrib><creatorcontrib>Sánchez Lechuga, Begoña</creatorcontrib><creatorcontrib>Bacon, Siobhan</creatorcontrib><creatorcontrib>Colclough, Kevin</creatorcontrib><creatorcontrib>Ng, Nicholas</creatorcontrib><creatorcontrib>Wong, Eleanor</creatorcontrib><creatorcontrib>Goulden, Eirena L.</creatorcontrib><creatorcontrib>Edwards, Jackie</creatorcontrib><creatorcontrib>Fleming, Aileen</creatorcontrib><creatorcontrib>Byrne, Bridgette</creatorcontrib><creatorcontrib>Byrne, Maria M.</creatorcontrib><title>Evaluation of pregnancy outcomes in women with GCK‐MODY</title><title>Diabetic medicine</title><addtitle>Diabet Med</addtitle><description>Aims
To determine the fetal and maternal outcomes in pregnant women with Glucokinase‐Maturity onset diabetes of the young (GCK‐MODY).
Methods
We studied the obstetric and perinatal outcomes in 99 pregnancies of 34 women with GCK‐MODY. The mutation status of the offspring was known in 29 and presumed in 33. Clinical outcomes were determined and compared between affected (n = 39) and unaffected (n = 23) offspring.
Results
59% of pregnancies were treated with diet alone and 41% received insulin. Birthweight, percentage of large for gestational age (LGA) and caesarean section (CS) in GCK‐unaffected offspring was significantly higher than in GCK‐affected offspring (4.0 ± 0.7 vs. 3.4 ± 0.4 kg, p = 0.001), 15 (65%) vs. 5(13%) (p = 0.00006) and 17 (74%) vs. 11 (28%) (p = 0.001), respectively. We observed an earlier gestational age at delivery on insulin in unaffected offspring (38.3 ± 1.0 vs. 39.5 ± 1.5 weeks, p = 0.03) with no significant change in LGA (9 (82%) vs. 6 (50%); p = 0.12), and a higher rate of CS (8 [73%] vs. 3 [11%]; p < 0.001), and no change in small for gestational age (0 [0%] vs. 4 [14%]; p = 0.30) in affected offspring.
Conclusion
Insulin therapy in unaffected offspring did not reduce LGA and was associated with earlier gestational age at delivery. Insulin treatment in GCK‐affected offspring was associated with an increased incidence of CS, but did not adversely affect fetal outcome. Fetal genotype determines birthweight rather than treatment. Pre‐pregnancy diagnosis of GCK‐MODY, use of continuous glucose monitoring and non‐invasive fetal genotyping may enable further investigation of targeted therapy in this condition.</description><subject>Adult</subject><subject>Age</subject><subject>Birth Weight</subject><subject>Blood Glucose - metabolism</subject><subject>Blood Glucose Self-Monitoring</subject><subject>Clinical outcomes</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes Mellitus, Type 2 - blood</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>Diabetes Mellitus, Type 2 - genetics</subject><subject>DNA - genetics</subject><subject>DNA Mutational Analysis</subject><subject>Female</subject><subject>Fetuses</subject><subject>Follow-Up Studies</subject><subject>Genotypes</subject><subject>Genotyping</subject><subject>Gestational Age</subject><subject>Gestational diabetes</subject><subject>Glucokinase</subject><subject>Glucokinase - genetics</subject><subject>Glucokinase - metabolism</subject><subject>Glucose monitoring</subject><subject>Humans</subject><subject>Incidence</subject><subject>Insulin</subject><subject>Maternal & child health</subject><subject>maturity‐onset diabetes of the young</subject><subject>Mutation</subject><subject>Offspring</subject><subject>Pedigree</subject><subject>Pregnancy</subject><subject>Pregnancy in Diabetics - blood</subject><subject>Pregnancy in Diabetics - epidemiology</subject><subject>Pregnancy in Diabetics - genetics</subject><subject>Pregnancy Outcome</subject><subject>Prenatal development</subject><subject>Retrospective Studies</subject><subject>Small for gestational age</subject><subject>Spain - epidemiology</subject><subject>Womens health</subject><issn>0742-3071</issn><issn>1464-5491</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kLFOwzAQhi0EoqUw8AIoEgsMaX22k9gjaktBtOoCA5OVOA6kSuISJ1TdeASekSfBkMKAxA13N3z6dPcjdAp4CK5GaamHwBjne6gPLGR-wATsoz6OGPEpjqCHjqxdYQxEUHGIepSSKIoo7iMxfY2LNm5yU3km89a1fqriSm090zbKlNp6eeVt3OJ63jx7s_Hdx9v7Yjl5PEYHWVxYfbKbA_RwPb0f3_jz5ex2fDX3FRWU-zRjHFSWilgzkYHgGuNE6YCkwLFIA04SrhJIAsJI5m4NBQEaAI-oUITGjA7QRedd1-al1baRZW6VLoq40qa1krAwCoFxBg49_4OuTFtX7jpJAvcxDYNQOOqyo1RtrK11Jtd1Xsb1VgKWX3lKl6f8ztOxZztjm5Q6_SV_AnTAqAM2eaG3_5vkZDHtlJ9VNnx_</recordid><startdate>202106</startdate><enddate>202106</enddate><creator>López Tinoco, Cristina</creator><creator>Sánchez Lechuga, Begoña</creator><creator>Bacon, Siobhan</creator><creator>Colclough, Kevin</creator><creator>Ng, Nicholas</creator><creator>Wong, Eleanor</creator><creator>Goulden, Eirena L.</creator><creator>Edwards, Jackie</creator><creator>Fleming, Aileen</creator><creator>Byrne, Bridgette</creator><creator>Byrne, Maria M.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4352-9655</orcidid><orcidid>https://orcid.org/0000-0002-9394-8698</orcidid></search><sort><creationdate>202106</creationdate><title>Evaluation of pregnancy outcomes in women with GCK‐MODY</title><author>López Tinoco, Cristina ; Sánchez Lechuga, Begoña ; Bacon, Siobhan ; Colclough, Kevin ; Ng, Nicholas ; Wong, Eleanor ; Goulden, Eirena L. ; Edwards, Jackie ; Fleming, Aileen ; Byrne, Bridgette ; Byrne, Maria M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3938-3f481cfd9ae49f198e00bce52d1809d582b8cb1b5242f30769213518739c23a43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Age</topic><topic>Birth Weight</topic><topic>Blood Glucose - metabolism</topic><topic>Blood Glucose Self-Monitoring</topic><topic>Clinical outcomes</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes Mellitus, Type 2 - blood</topic><topic>Diabetes Mellitus, Type 2 - epidemiology</topic><topic>Diabetes Mellitus, Type 2 - genetics</topic><topic>DNA - genetics</topic><topic>DNA Mutational Analysis</topic><topic>Female</topic><topic>Fetuses</topic><topic>Follow-Up Studies</topic><topic>Genotypes</topic><topic>Genotyping</topic><topic>Gestational Age</topic><topic>Gestational diabetes</topic><topic>Glucokinase</topic><topic>Glucokinase - genetics</topic><topic>Glucokinase - metabolism</topic><topic>Glucose monitoring</topic><topic>Humans</topic><topic>Incidence</topic><topic>Insulin</topic><topic>Maternal & child health</topic><topic>maturity‐onset diabetes of the young</topic><topic>Mutation</topic><topic>Offspring</topic><topic>Pedigree</topic><topic>Pregnancy</topic><topic>Pregnancy in Diabetics - blood</topic><topic>Pregnancy in Diabetics - epidemiology</topic><topic>Pregnancy in Diabetics - genetics</topic><topic>Pregnancy Outcome</topic><topic>Prenatal development</topic><topic>Retrospective Studies</topic><topic>Small for gestational age</topic><topic>Spain - epidemiology</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>López Tinoco, Cristina</creatorcontrib><creatorcontrib>Sánchez Lechuga, Begoña</creatorcontrib><creatorcontrib>Bacon, Siobhan</creatorcontrib><creatorcontrib>Colclough, Kevin</creatorcontrib><creatorcontrib>Ng, Nicholas</creatorcontrib><creatorcontrib>Wong, Eleanor</creatorcontrib><creatorcontrib>Goulden, Eirena L.</creatorcontrib><creatorcontrib>Edwards, Jackie</creatorcontrib><creatorcontrib>Fleming, Aileen</creatorcontrib><creatorcontrib>Byrne, Bridgette</creatorcontrib><creatorcontrib>Byrne, Maria M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetic medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>López Tinoco, Cristina</au><au>Sánchez Lechuga, Begoña</au><au>Bacon, Siobhan</au><au>Colclough, Kevin</au><au>Ng, Nicholas</au><au>Wong, Eleanor</au><au>Goulden, Eirena L.</au><au>Edwards, Jackie</au><au>Fleming, Aileen</au><au>Byrne, Bridgette</au><au>Byrne, Maria M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluation of pregnancy outcomes in women with GCK‐MODY</atitle><jtitle>Diabetic medicine</jtitle><addtitle>Diabet Med</addtitle><date>2021-06</date><risdate>2021</risdate><volume>38</volume><issue>6</issue><spage>e14488</spage><epage>n/a</epage><pages>e14488-n/a</pages><issn>0742-3071</issn><eissn>1464-5491</eissn><abstract>Aims
To determine the fetal and maternal outcomes in pregnant women with Glucokinase‐Maturity onset diabetes of the young (GCK‐MODY).
Methods
We studied the obstetric and perinatal outcomes in 99 pregnancies of 34 women with GCK‐MODY. The mutation status of the offspring was known in 29 and presumed in 33. Clinical outcomes were determined and compared between affected (n = 39) and unaffected (n = 23) offspring.
Results
59% of pregnancies were treated with diet alone and 41% received insulin. Birthweight, percentage of large for gestational age (LGA) and caesarean section (CS) in GCK‐unaffected offspring was significantly higher than in GCK‐affected offspring (4.0 ± 0.7 vs. 3.4 ± 0.4 kg, p = 0.001), 15 (65%) vs. 5(13%) (p = 0.00006) and 17 (74%) vs. 11 (28%) (p = 0.001), respectively. We observed an earlier gestational age at delivery on insulin in unaffected offspring (38.3 ± 1.0 vs. 39.5 ± 1.5 weeks, p = 0.03) with no significant change in LGA (9 (82%) vs. 6 (50%); p = 0.12), and a higher rate of CS (8 [73%] vs. 3 [11%]; p < 0.001), and no change in small for gestational age (0 [0%] vs. 4 [14%]; p = 0.30) in affected offspring.
Conclusion
Insulin therapy in unaffected offspring did not reduce LGA and was associated with earlier gestational age at delivery. Insulin treatment in GCK‐affected offspring was associated with an increased incidence of CS, but did not adversely affect fetal outcome. Fetal genotype determines birthweight rather than treatment. Pre‐pregnancy diagnosis of GCK‐MODY, use of continuous glucose monitoring and non‐invasive fetal genotyping may enable further investigation of targeted therapy in this condition.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33277730</pmid><doi>10.1111/dme.14488</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-4352-9655</orcidid><orcidid>https://orcid.org/0000-0002-9394-8698</orcidid></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Age Birth Weight Blood Glucose - metabolism Blood Glucose Self-Monitoring Clinical outcomes Diabetes Diabetes mellitus Diabetes Mellitus, Type 2 - blood Diabetes Mellitus, Type 2 - epidemiology Diabetes Mellitus, Type 2 - genetics DNA - genetics DNA Mutational Analysis Female Fetuses Follow-Up Studies Genotypes Genotyping Gestational Age Gestational diabetes Glucokinase Glucokinase - genetics Glucokinase - metabolism Glucose monitoring Humans Incidence Insulin Maternal & child health maturity‐onset diabetes of the young Mutation Offspring Pedigree Pregnancy Pregnancy in Diabetics - blood Pregnancy in Diabetics - epidemiology Pregnancy in Diabetics - genetics Pregnancy Outcome Prenatal development Retrospective Studies Small for gestational age Spain - epidemiology Womens health |
| title | Evaluation of pregnancy outcomes in women with GCK‐MODY |
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