Subsequent gestational diabetes mellitus prediction in advanced maternal age using amniotic fluid glucose concentration during second trimester genetic amniocentesis

Abstract

This prospective study aimed to present the reference range of amniotic fluid glucose (AFglu) among second trimester pregnant women in southern Thailand, to evaluate the possibility of predicting subsequent gestational diabetes mellitus (GDM) using AFglu, and to estimate AFglu cut-off levels for identifying pregnancies at high or low risk for subsequent GDM in singleton pregnancies undergoing genetic amniocentesis due to advanced maternal age. A total of 438 eligible pregnant women were analysed, among whom 58 were subsequently diagnosed as having GDM. The reference range that included the central 95% of AFglu values at 16, 17 and 18 weeks of gestation in women not subsequently developing GDM was determined from a linear regression model. Logistic regression was used to identify predictors of subsequent GDM. Odds ratio of subsequent diagnosed GDM participant increased by 7% for each 1 mg/dl increase in AFglu. Risk of subsequent GDM was also increased in women aged over 36 years and in 17–18 weeks compared to 16 weeks of gestation. Depending on gestational and maternal age, AFglu levels above 51 to 75 mg/dl were at elevated risk of subsequent GDM (likelihood ratio 2.38). We conclude that AFglu tended to decrease with increasing of gestational age. Gestational age and maternal age accompanied with elevated AFglu are predictive factors for subsequent GDM.

Keywords::

• Amniotic fluid
• glucose
• gestational diabetes
• prediction

Acknowledgements

The authors would like to thank the International Affairs Office, Faculty of Medicine, Prince of Songkla University, for his editorial assistance and Miss Walailuk Jitpiboon, Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, for help with statistical analysis.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.