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Risk of gestational diabetes mellitus in patients undergoing assisted reproductive techniques.
[cushing syndrome]
To
compare
the
incidence
of
gestational
diabetes
mellitus
(
GDM
)
between
pregnancies
conceived
spontaneously
and
pregnancies
conceived
following
assisted
reproductive
technology
(
ART
)
.
This
cross-sectional
study
evaluated
the
medical
records
of
215
women
who
conceived
spontaneously
and
145
women
who
conceived
following
ART
from
September
2011
to
October
2012
.
Exclusion
criteria
were
:
polycystic
ovary
syndrome
,
maternal
age
≥
40
years
,
family
history
of
diabetes
in
first
-degree
relatives
,
pre-pregnancy
diabetes
,
glucose
intolerance
treated
with
hypoglycaemic
agent
(
e
.
g
.
metformin
)
,
history
of
GDM
,
history
of
stillbirth
,
recurrent
miscarriage
,
history
of
baby
with
birth
weight
≥
4
kg
(
macrosomia
)
,
parity
>
3
,
Cushing
syndrome
,
congenital
adrenal
hyperplasia
and
hypothyroidism
.
For
better
comparison
of
the
incidence
of
GDM
,
the
ART
group
was
further
subdivided
into
:
(
i
)
an
in
-vitro
fertilization
/
intracytoplasmic
sperm
injection
(
IVF
/
ICSI
)
group
(
n
=
95
)
;
and
(
ii
)
an
intrauterine
insemination
(
IUI
)
group
(
n
=
50
)
.
The
diagnosis
of
GDM
was
based
on
the
criteria
of
the
American
Diabetes
Association
.
The
incidence
of
GDM
was
significantly
higher
in
the
IVF
/
ICSI
and
IUI
groups
(
43
%
and
26
%
,
respectively
)
compared
with
the
spontaneous
pregnancy
group
(
10
%
)
.
Age
,
pre-pregnancy
body
mass
index
(
BMI
)
and
weight
gain
in
pregnancy
were
similar
among
women
with
GDM
in
all
three
groups
.
In
addition
,
the
incidence
of
pregnancy-induced
hypertension
was
significantly
higher
in
the
IVF
/
ICSI
group
(
21
%
)
compared
with
the
spontaneous
pregnancy
group
(
7
%
)
.
Logistic
regression
analysis
demonstrated
four
strong
risk
factors
for
GDM
:
age
,
BMI
,
mode
of
ART
and
progesterone
use
during
pregnancy
.
This
study
indicated
that
the
risk
of
GDM
is
two-fold
higher
in
women
with
singleton
pregnancies
conceived
following
ART
compared
with
women
who
conceived
spontaneously
.
In
addition
,
progesterone
use
during
pregnancy
was
found
to
be
an
important
risk
factor
for
GDM
.
This
subject
requires
further
study
.
Diseases
Validation
Diseases presenting
"diabetes in first-degree relatives"
symptom
congenital adrenal hyperplasia
cushing syndrome
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