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Familial History of Diabetes, Hypertension Are Potential Predictors of Gestational Diabetes
posted 02/13/04

Pregnant women with a first-degree family history of type 2 diabetes have a 2 to 8-fold greater risk of gestational diabetes mellitus (GDM) than do women without such a family history, especially those who have at least one sibling with diabetes, according to an American case-control study. Furthermore, women who have a sibling with chronic hypertension also have a 2 to 3-fold increased risk of GDM.

GDM is associated with significant short- and long-term adverse health outcomes for both mothers and their offspring. However, little information is available regarding the aetiology and pathophysiology of this common complication of pregnancy.

While parental history of diabetes has been shown to be predictive of GDM, the patterns and degree of risk have not been fully investigated.

Michelle A Williams, ScD, and colleagues at the Swedish Medical Centre, Seattle, Washington, United States, evaluated the influence of parental and sibling history of type 2 diabetes and hypertension on risk of GDM.

The study included 133 women with GDM and 373 pregnant women with normal blood pressure and no evidence of GDM. All women completed an interview questionnaire during the postpartum hospital stay to assess first-degree family history of diabetes and hypertension.

Parental history of type 2 diabetes was associated with a 2.3-fold increased risk of GDM, after adjusting for maternal age, race/ethnicity, parity, annual household income and pre-pregnancy body mass index.

Moreover, women who reported both maternal and paternal history of diabetes had a 3.8-fold increased risk of GDM. Maternal only and paternal only history of diabetes conferred the same degree of risk, 2.0 and 2.2-fold, respectively.

Women with at least one diabetic sibling had the greatest risk of GDM. These women had an 8.4-fold greater risk of GDM than those whose siblings were all non-diabetic. Moreover, sibling history of diabetes, even in the absence of parental history, was associated with a 5-fold increased risk of GDM.

Sibling history of hypertension alone or in combination with parental history was also associated with a 2.3-fold and 3.4-fold increased risk of GDM, respectively. However, parental history alone did not significantly affect the risk of GDM.

Women with a parental history of both diabetes and hypertension had a 2.6-fold increased risk of GDM as compared to women whose parents were neither diabetic nor hypertensive.

The authors conclude that there is a greater incidence of GDM in families with a history of type 2 diabetes mellitus. They add that this association may be due to "inherited susceptibility and/or to shared behaviours and environmental exposures including diet, tobacco use, sedentary lifestyle or other factors."

Source: Diabetes In Control.com: J Reprod Med 2003 Dec;48:12:955-62.

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