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3 Pre-pregnancy body surface area and risk for gestational diabetes mellitus
  1. Lotta Holopainen1,
  2. Hanna Tähtinen1,
  3. Mika Gissler2,3,4,5,
  4. Päivi Korhonen1,
  5. Mikael Ekblad1
  1. 1Department of General Practice, Institute of Clinical Medicine, University of Turku and Turku University Hospital, Turku, Finland
  2. 2THL Finnish Institute for Health and Welfare, Department of Knowledge Brokers, Helsinki, Finland
  3. 3Research Centre for Child Psychiatry, University of Turku, Turku, Finland
  4. 4Karolinska Institute, Department of Molecular Medicine and Surgery, Stockholm, Sweden
  5. 5Region Stockholm, Academic Primary Health Care Centre, Stockholm, Sweden


Objectives To evaluate the effect of the pre-pregnancy body surface area (BSA) on the risk of gestational diabetes mellitus (GDM).

Method The study population consisted of all primiparous women with singleton pregnancies (n = 328,892) without previously diagnosed diabetes or chronic hypertension in Finland between 2006 and 2019. The information on GDM, oral glucose tolerance test (OGTT) results, and maternal backgrounds were derived from the Finnish Medical Birth Register. The pre-pregnancy BSA was calculated by using the Mosteller formula. Logistic regression models were used to estimate the association between BSA and GDM/OGTT separately by the body mass index groups.

Results A lower BSA predicted an increased risk for GDM and pathological OGTT among the underweight (b = -2.69, SE = 0.25, p < 0.001; b = -2.66, SE = 0.23, p < 0.001, respectively) pregnant women, and normal weight (b = -0.30, SE = 0.10, p = 0.002; b = -0.67, SE = 0.09, p < 0.001, respectively) pregnant women; and pathological OGTT among the overweight (b = -0.31, SE = 0.10, p = 0.001) pregnant women. Within the obese class II or greater, a higher BSA predicted a higher risk for GDM (b = 0.74, SE = 0.12, p < 0.001) and pathological OGTT (b = 0.79, SE = 0.13, p < 0.001). Maternal smoking predicted a significantly higher risk of GDM and pathological OGTTs in almost all body mass index groups.

Conclusions This study showed that in comparison to women with a higher BSA, underweight and normal weight pregnant women with a smaller BSA may be more susceptible to GDM and have a pathological OGTT.

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