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IVF raises gestational diabetes risk
Women who conceive through in vitro fertilization are at increased risk for gestational diabetes compared with women who conceive spontaneously, and the risk is more pronounced in women with overweight or obesity, according to study findings.
Yap Seng Chong, MD, associate professor in the department of obstetrics and gynecology at Yong Loo Lin School of Medicine, National University of Singapore, and colleagues evaluated data from the Singapore birth cohort study on 1,089 Asian women with singleton pregnancies who received a 75-g oral glucose tolerance test at 26 to 28 weeks’ gestation. Researchers sought to determine whether in vitro fertilization (IVF) increases the risk for gestational diabetes and whether maternal BMI modifies any risk increase. Among the participants, 1,013 conceived spontaneously and 76 conceived through IVF.
The odds of developing gestational diabetes were doubled among participants who conceived through IVF compared with those who conceived spontaneously in the unadjusted analysis (OR = 2.02; 95% CI, 1.21-3.39), and the risk remained higher after adjustment for maternal age, ethnicity, first-trimester maternal BMI, family history of diabetes, previous history of gestational diabetes and prior history of macrosomia (adjusted OR = 1.83; 95% CI, 1.03-3.26). The IVF group had significantly higher values for fasting glucose and 2-hour glucose OGTT before (fasting glucose, P = .029; OGTT, P < .01) and after (fasting glucose, P = .05; OGTT, P = .001) adjustment for covariates compared with the group who conceived spontaneously.
When participants were divided by first trimester BMI, participants with BMI 25 kg/m2 or greater who conceived through IVF continued to have a higher risk for gestational diabetes (aOR = 3.54; 95% CI, 1.44-8.72) and higher fasting (adjusted mean difference, 0.39 mmol/L; 95% CI, 0.13-0.65) and 2-hour OGTT blood glucose values (adjusted mean difference, 1.24 mmol/L; 95% CI, 0.56-1.91) compared with participants with BMI less than 25 kg/m2 who underwent IVF.
Researchers suggest that women should be advised to lose weight before beginning IVF to reduce their risk for gestational diabetes and hyperglycemia and women with overweight or obesity who conceive through IVF should be screened for gestational diabetes using an OGTT. – by Amber Cox
Disclosures: Chong receives lecture fees from Danone and Nestle Nutrition Institute. Please see the full study for a list of all other authors’ relevant financial disclosures.