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. 2018 Dec;19(4):367-372.
doi: 10.1089/ham.2018.0012. Epub 2018 Oct 3.

Gestational Diabetes Prevalence at Moderate and High Altitude

Anna G Euser  1 , Andrew Hammes  2 , Jared T Ahrendsen  3 , Barbara Neshek  3 , David A Weitzenkamp  2 , Javier Gutierrez  4 , Peppi Koivunen  5 , Colleen G Julian  6 , Lorna G Moore  1
Affiliations

Gestational Diabetes Prevalence at Moderate and High Altitude

Anna G Euser et al. High Alt Med Biol. 2018 Dec.

Abstract

Background: High-altitude (HA) pregnancies have been associated with decreased glucose levels and increased insulin sensitivity versus sea level. Our objective was to determine if the prevalence of gestational diabetes mellitus (GDM) and the impact of demographic characteristics on GDM diagnosis differed at moderate altitude (MA) versus HA.

Methods: Using a retrospective cohort design, we compared women living at HA (>8250 ft) and MA (4000-7000 ft) during pregnancy. Exclusion criteria were as follows: multiple gestation, preexisting diabetes, unavailable GDM results, or relocation from a different altitude during pregnancy. GDM diagnosis was determined using Carpenter and Coustan criteria. Data were compared by t-test (continuous variables) or chi-squared tests (categorical variables). Univariate, multivariate, and stepwise regression models were used to assess the impact of various factors on GDM prevalence.

Results: There was no difference in GDM prevalence between altitudes in these populations; the relationship between altitude and GDM was nonsignificant in all regression analyses. At MA, maternal age, Hispanic ethnicity, body mass index (BMI), and gestational age (GA) at testing increased GDM incidence in univariate analyses. At HA, maternal age, Hispanic ethnicity, and multiparity increased GDM incidence in univariate analyses.

Conclusion: While GDM prevalence did not differ between MA and HA, the impact of maternal demographic characteristics on GDM risk varied by altitude group. Higher BMI and greater GA at testing increased the incidence of GDM at MA, but not at HA. Multiparity had an effect at HA, but not MA. These differences may represent subtle differences in glucose metabolism at HA.

Keywords: Colorado; gestational diabetes; high altitude; pregnancy.

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Conflict of interest statement

No competing financial interests exist. Contents are the authors' sole responsibility and do not necessarily represent official NIH views.

Figures

<b>FIG. 1.</b>
FIG. 1.
Flow diagram for moderate-altitude cohort. GDM, gestational diabetes mellitus.
<b>FIG. 2.</b>
FIG. 2.
Flow diagram for high-altitude cohort. DM, diabetes mellitus.
See this image and copyright information in PMC

References

    1. American College of Obstetricians and Gynecologists. (2017). Gestational diabetes mellitus. Practice Bulletin No. 180. Obstet Gynecol 130:e17–e31 - PubMed
    1. Bardenheier BH, Imperatore G, Gilboa SM, Geiss LS, Saydah SH, Devlin HM, Kim SY, and Gregg EW. (2015). Trends in gestational diabetes among hospital deliveries in 19 U.S. states, 2000–2010. Am J Prev Med 49:12–19 - PMC - PubMed
    1. Bigham AW, Julian CG, Wilson MJ, Vargas E, Browne VA, Shriver MD, and Moore LG. (2014). Maternal PRKAA1 and EDNRA genotypes are associated with birth weight, and PRKAA1 with uterine artery diameter and metabolic homeostasis at high altitude. Physiol Genomics 46:687–697 - PMC - PubMed
    1. Braun B, Butterfield GE, Dominick SB, Zamudio S, McCullough RG, Rock PB, and Moore LG. (1998). Women at altitude: Changes in carbohydrate metabolism at 4,300-m elevation and across the menstrual cycle. J Appl Physiol 85:1966–1973 - PubMed
    1. Castillo O, Woolcott OO, Gonzales E, Tello V, Tello L, Villarreal C, Mendez N, Damas L, and Florentini E. (2007). Residents at high altitude show a lower glucose profile than sea-level residents throughout 12-hour blood continuous monitoring. High Alt Med Biol 8:307–311 - PubMed

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