Association of body composition in early pregnancy with gestational diabetes mellitus: A meta-analysis

Abstract

Introduction: Body composition as dynamic indices constantly changes in pregnancy. The use of body composition indices in the early stages of pregnancy has recently been considered. Therefore, the current meta-analysis study was conducted to investigate the relationship between body composition in the early stages of pregnancy and gestational diabetes.

Method: Valid databases searched for papers published from 2010 to December 2021 were based on PRISMA guideline. Newcastle Ottawa was used to assess the quality of the studies. For all analyses, STATA 14.0 was used. Mean difference (MD) of anthropometric indices was calculated between the GDM and Non-GDM groups. Pooled MD was estimated by "Metan" command, and heterogeneity was defined using Cochran's Q test of heterogeneity, and I 2 index was used to quantify heterogeneity.

Results: Finally, 29 studies with a sample size of 56438 met the criteria for entering the meta-analysis. Pooled MD of neck circumference, hip circumference, waist hip ratio, and visceral adipose tissue depth were, respectively, 1.00 cm (95% CI: 0.79 to 1.20) [N = 5; I^2: 0%; p: 0.709], 7.79 cm (95% CI: 2.27 to 13.31) [N = 5; I2: 84.3%; P<0.001], 0.03 (95% CI: 0.02 to 0.04) [N = 9; I2: 89.2%; P<0.001], and 7.74 cm (95% CI: 0.11 to 1.36) [N = 4; I^2: 95.8%; P<0.001].

Conclusion: Increased neck circumference, waist circumference, hip circumference, arm circumference, waist to hip ratio, visceral fat depth, subcutaneous fat depth, and short stature increased the possibility of developing gestational diabetes. These indices can accurately, cost-effectively, and affordably assess the occurrence of gestational diabetes, thus preventing many consequences with early detection of gestational diabetes.

Fig 1. PRISMA flowchart of selected studies.

Fig 2. Forest plot for MD of waist circumference (cm) between GMD and non-GDM group based on a random effects model.

Each study is distinguished by its author (year) and countries. Each line segment’s midpoint shows the MD estimate; the length of line segment indicates 95% confidence interval (CI) in each study, and the diamond mark illustrates the pooled estimate of MD.

Fig 3. Pooled MD and 95% confidence interval of anthropometric index.

The diamond mark illustrates the pooled MD, and the length of the diamond indicates 95% CI.

Fig 4

Association between pooled mean difference (MD) of waist circumference with age (A) and publication year (B) by means of meta regression. The size of circles indicates the precision of each study. There is no significant association with respect to the pooled MD of waist circumference with age publication year.