Risk Factors for Gestational Diabetes
By Dr. Kate Dudek
One of the biggest risk factors for the development of gestational diabetes is obesity. Fortunately this is a risk you can reduce by making lifestyle adjustments and losing weight. Unfortunately, some of the other risk factors for gestational diabetes cannot be controlled in the same way and in these cases your doctor will probably suggest you get screened during your pregnancy.
Known risk factors include a family history of diabetes, gestational diabetes during a previous pregnancy, a history of recurrent miscarriage, polycystic ovary syndrome and maternal age. Some guidelines state that women over 35 are at increased risk of gestational diabetes, however others, suggest screening for all women over 25 years of age. Short stature is another risk factor, although there is no clear answer as to why this would be the case. One suggestion is that genetics are involved, with common gene polymorphisms affecting both growth hormones and glucose metabolism, thus predisposing short females to metabolic conditions such as gestational diabetes. Alternatively, inadequate foetal nutrition has been directly associated with short stature and impaired glucose tolerance in adulthood. Finally, shorter females might just respond differently to the oral glucose tolerance test, as they have less metabolically active tissue than taller women.
Experiencing other pregnancy complications, including polyhydramnios, hypertension and preeclampsia can also increase your risk of developing gestational diabetes.
One of the strongest non-modifiable risk factors is ethnicity. Women in certain populations, including India, the Middle East and South Asia are significantly more likely to develop gestational diabetes. Furthermore, many of the Asian women who develop it, have a normal BMI, so management strategies for the condition in these parts of the world may have to differ from those places where obesity is the driving factor.
Depression during pregnancy has also been linked to the development of gestational diabetes, although there is debate over the validity of the association. Perhaps the fact that both conditions are fairly common, means that it is inevitable that a significant number of women will experience both, without one necessarily causing the other. If there is a direct correlation between the two, non-obese women who experience depression during the first and second trimesters appear to be at greatest risk. There is also evidence that women who have had gestational diabetes have an increased risk of postnatal depression, potentially due to the hormonal fluctuations that occur with childbirth. This highlights how important it is to look after your mental health during pregnancy and following delivery.
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- Cianni, G D, et al. “Prevalence and Risk Factors for Gestational Diabetes Assessed by Universal Screening.” Diabetes Research and Clinical Practice, vol. 62, no. 2, Nov. 2003, pp. 131–137., doi:10.1016/j.diabres.2003.07.004.
- Hinkle, S N, et al. “A Longitudinal Study of Depression and Gestational Diabetes in Pregnancy and the Postpartum Period.” Diabetologia, vol. 59, no. 12, Dec. 2016, pp. 2594–2602., doi:10.1007/s00125-016-4086-1.
- Larrabure-Torrealva, G T, et al. “Prevalence and Risk Factors of Gestational Diabetes Mellitus: Findings from a Universal Screening Feasibility Program in Lima, Peru.” BMC Pregnancy and Childbirth, vol. 18, no. 1, 18 July 2018, p. 303., doi:10.1186/s12884-018-1904-0.
- Pons, R S, et al. “Risk Factors for Gestational Diabetes Mellitus in a Sample of Pregnant Women Diagnosed with the Disease.” Diabetology and Metabolic Syndrome, vol. 7, no. Suppl. 1, 11 Nov. 2015, p. A80., doi:10.1186/1758-5996-7-S1-A80.