Assisted Reproductive Technology: Predictive Factors for Gestational Diabetes Mellitus

Background: Well-known predictors for development of diabetesin spontaneous pregnancy are maternal age, obesity, andfamily history of diabetes. To date, studies concerning ARToutcomes were unable to establish gestational diabetes mellitus(GDM) risk factors during ART procedures. It remains unclearwhich ART characteristic(s) is able to predict GDM in thesesubjects. Present study was performed to evaluate predictivefactors for GDM in singleton pregnancy following assistedconception.Materials and Methods: This nested case-control study wasperformed during October ۲۰۱۶ to June ۲۰۱۷. Pregnant womenwho conceived following ART procedures referred to infertilityclinic were selected and categorized into GDM and non-GDMbased on ADA/IAPDSG criteria. The study variables includingage, educational status, and first-degree family history ofchronic diseases, systolic and diastolic blood pressure, previousobstetric and perinatal outcomes, infertility history, and ARTcycle characteristics were collected from medical records. Predictionmodel to develop GDM was employed by binary logisticregression analysis after adjustment for age and body massindex, family history of diabetes, and gravidity.Results: In total, ۲۷۰ women with singleton pregnancies (consistedof ۱۳۵ GDM and ۱۳۵ non-GDM women) conceived werestudied. According to the final model, significant predictors ofGDM were history of polycystic ovarian syndrome (PCOS),previous ovarian hyper-stimulation syndrome (OHSS) risk andprogesterone injections. Administration of injectable progesteroneduring the first ۱۰-۱۲ weeks of pregnancy was associatedwith an approximately two-fold increased risk of developingGDM [odds ratio (OR) ۲.۲۸, ۹۵% confidence interval (CI) ۱.۲۷-۴.۰۹) ] compared to vaginal progesterone. In addition, the regressionanalysis revealed that previous OHSS risk (OR ۲.۴۰,۹۵% CI ۱.۳۴-۴.۳۱) and history of PCOS (OR ۲.۷۶, ۹۵% CI۱.۲۶-۶.۰۶) were other most important predictors of GDM.Conclusion: The route of progesterone administration, previousOHSS risk and history of PCOS seem to be putative riskfactors for GDM in women conceived by ART.These findingscould be considered in patients' consultation before ART andafter achieving pregnancy.

کلیدواژه ها:

Gestational Diabetes Mellitus ، Assisted Reproductive Technology ، Predictive Factors