The prevalence of gestational diabetes (GD) continues to increase worldwide, as diabetes mellitus type 2, with the increasing overweight and age of pregnancy. The Caucasian race is the group with a low risk factor in addition to age <25 years and BMI<25. In Italy, the recent immigration of different ethnies with high natality have changed in the last decade the epidemiologic profile of pregnant women. We assessed the prevalence of gestational diabetes in the view of ethnic modification.
From January 2004 to June 2006, we evaluated 2400 mothernewborn pairs. Glucose challenge test (GCT) was performed at 2728th week of gestation. If the test was positive (>140 mg/dl at 60″) an oral glucose tolerance test (100 g of glucose) for 3 h was performed and Carpenter-Coustan criteria were followed. Seventy-five percent pregnant women were Italian and 25% non Italian. In the last group, only 13% were European women; among extra-European group 37.1% of women came from Asia, 36.5% from South America, 22.2% from Africa and 4% from USA.
GD diagnosed by GCT in 182 cases (7.5%) was confirmed by OGTT in 132 (5.5%). The incidence of GD has been 4.7% in Italian women and 9% in extra-European women showing a significant difference (P<0.001). Only in 7.5% glucose intolerance was associated with weight increase in pregnancy more than 20 kg. Asian women were at the highest risk (15%) also compared to women from South America (11%). Neonatal complications were hypoglycemia (5.8%) and respiratory distress (3.4%).
Immigrant women are at high risk of impaired glucose tolerance with a higher incidence of cesarian sections and complications of their newborns. The ethnic factor is an independent risk factor in developing impaired glucose tolerance.
03 - 07 May 2008
European Society of Endocrinology