The pre-pregnancy fasting blood glucose, glycated hemoglobin and lipid profiles as blood biomarkers for gestational diabetes mellitus: evidence from a multigenerational cohort study.

Background: Early prevention of gestational diabetes mellitus (GDM) is important to reduce the risk of adverse pregnancy outcomes and post-pregnancy cardiometabolic risk in women and offspring over the life course. This study aimed to investigate some blood biomarkers before pregnancy as GDM predictors.

Methods: We investigated the prospective association of blood biomarkers before pregnancy and GDM risk among women from the Mater-University of Queensland Study of Pregnancy (MUSP) cohort. A multiple logistic regression model was applied to estimate the odds of experiencing GDM by blood biomarkers.

Results: Out of 525 women included in this study, the prevalence of GDM was 7.43%. There was an increased risk of experiencing GDM among women who experienced obesity (Odds ratio = OR 2.4; 95% confidence interval = CI 1.6-3.7), had high fasting blood glucose (OR = 2.2; 95% CI = 1.3-3.8), high insulin (OR = 1.1; 95% CI = 1.0-1.2), high insulin resistance (OR = 1.2; 95% CI = 1.0-1.3) and low high-density lipoprotein (OR = 0.2; 95% CI = 0.1-0.7) before pregnancy. Adjustment for potential confounders, such as age, marital status, and BMI did not attenuate these associations substantially.

Conclusion: The pre-pregnancy fasting blood glucose, insulin, and insulin resistance were independent predictors of GDM. They may be used as early markers for predicting the incidence of GDM.