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Predictive factors of gestational diabetes in pregnancies following assisted reproductive technology: a nested case–control study

  • Gynecologic Endocrinology and Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To evaluate predictive factors for gestational diabetes mellitus (GDM) in singleton pregnancy following assisted reproductive technology (ART).

Methods

This nested case–control study was performed during October 2016–June 2017. Pregnant women who conceived following ART procedures referred to infertility clinic were selected and categorized into GDM and non-GDM based on ADA/IAPDSG criteria. The study variables including age, educational status, first-degree family history of chronic diseases, systolic and diastolic blood pressure, previous obstetric and perinatal outcomes, infertility history, and ART cycle characteristics were collected from medical records. Prediction model to develop GDM was employed by binary logistic regression analysis after adjustment for age and body mass index, family history of diabetes, and gravidity.

Results

In total, 270 women with singleton pregnancies (consisted of 135 GDM and 135 non-GDM women) conceived were studied. According to the final model, significant predictors of GDM were history of polycystic ovarian syndrome (PCOS), previous ovarian hyper-stimulation syndrome (OHSS) risk and progesterone injections. Administration of injectable progesterone during the first 10–12 weeks of pregnancy was associated with an approximately twofold increased risk of developing GDM [odds ratio (OR) 2.28, 95% confidence interval (CI) 1.27–4.09)] compared to vaginal progesterone. In addition, the regression analysis revealed that previous OHSS risk (OR 2.40, 95% CI 1.34–4.31) and history of PCOS (OR 2.76, 95% CI 1.26–6.06) were other most important predictors of GDM.

Conclusions

The route of progesterone administration, previous OHSS risk and history of PCOS seem to be putative risk factors for GDM in women conceived by ART.

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Acknowledgements

The author would like to thank Royan institute personnel’s and patients for their invaluable contributions to this research performance.

Funding

No financial support has been granted.

Author information

Authors and Affiliations

  1. Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran

    Azam Kouhkan, Mohammad E. Khamseh, Ameneh Ebrahim Valojerdi & Hamid Reza Baradaran

  2. Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran

    Azam Kouhkan, Ashraf Moini, Arezoo Arabipoor & Roya Hosseini

  3. Department of Gynecology and Obstetrics, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Ashraf Moini & Reihaneh Pirjani

  4. Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran

    Ashraf Moini

  5. Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran

    Roya Hosseini

Authors
  1. Azam Kouhkan
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  2. Mohammad E. Khamseh
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  3. Ashraf Moini
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  4. Reihaneh Pirjani
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  5. Ameneh Ebrahim Valojerdi
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  6. Arezoo Arabipoor
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  7. Roya Hosseini
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  8. Hamid Reza Baradaran
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Contributions

AK (M.D): designing the research, patient selection, collecting data, manuscript writing/editing. MEK (M.D): design, project development, revising manuscript, approve for publication. AM (M.D): design, patient selection, revising manuscript. RP (M.D): design and revising manuscript. AEV (M.D): design, analysing data, manuscript editing. AA (M.Sc): data collection, revising manuscript. RH (M.D): design, patient selection, data collection, revising manuscript. HRB (Ph.D.): design and methodology, analysis and interpretation of data, manuscript editing.

Corresponding authors

Correspondence to Roya Hosseini or Hamid Reza Baradaran.

Ethics declarations

Conflict of interest

Author Azam Kouhkan declares that she has no conflict of interest. Author Mohammad E. Khamseh declares that he has no conflict of interest. Author Ashraf Moini declares that she has no conflict of interest. Author Reihaneh Pirjani declares that she has no conflict of interest. Author Ameneh Ebrahim Valojerdi declares that she has no conflict of interest. Author Arezoo Arabipoor declares that she has no conflict of interest. Author Roya Hosseini declares that she has no conflict of interest. Author Hamid Reza Baradaran declares that he has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of Iran University of Medical Science and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed written consent was obtained from all individual participants included in the study.

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Kouhkan, A., Khamseh, M.E., Moini, A. et al. Predictive factors of gestational diabetes in pregnancies following assisted reproductive technology: a nested case–control study. Arch Gynecol Obstet 298, 199–206 (2018). https://doi.org/10.1007/s00404-018-4772-y

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  • DOI: https://doi.org/10.1007/s00404-018-4772-y

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