Résumé
Aims: To explore the glucose-overload hypothesis of artefactual gestational diabetes (GDM) diagnosis in shorter women during oral glucose tolerance testing (OGTT), by investigating associations between height and maternal glycemia; and GDM and pregnancy complications in height-groups. Methods: Women from GUSTO (n = 1100, 2009-2010) and NUH (n = 4068, 2017-2018) cohorts underwent a mid-gestation two and three time-point 75 g 2-hour OGTT, respectively. GDMrelated complications (hypertensive disorders of pregnancy, preterm delivery, emergency cesarean section, neonatal intensive care unit admission, macrosomia, birthweight) were compared within shorter and taller groups, dichotomized by ethnic-specific median height. Results: Using WHO-1999 criteria, 18.8% (GUSTO) to 22.9% (NUH) of women were diagnosed with GDM-1999; and by WHO-2013 criteria, 21.9% (NUH) had GDM-2013. Each 5-cm height increment was inversely associated with GDM-1999 (adjusted odds ratio [aOR, 95% CI] = 0.81 [0.76-0.87], 2-h glycemia (adjusted 13 [a13, 95% CI] =-0.171 mmol/L [-0.208,-0.135]) and 1-h glycemia (a13 =-0.160 mmol/L [-0.207,-0.112]). The inverse association between height and 2-h glycemia was most marked in "Other" ethnicities (Eurasians/Cau casians/mixed/other Asians) and Indians, followed by Chinese, then Malays. Compared with non-GDM, GDM-1999 was associated with preterm delivery (aOR = 1.76 [1.19-2.61]) and higher birthweight (a13 = 57.16 g [20.95, 93.38]) only among taller but not shorter women. Conclusions: Only taller women had an increased odds of GDM-related pregnancy complica- tions. An artefactual GDM diagnosis due to glucose-overload among shorter women is plausible. (c) 2021 Elsevier B.V. All rights reserved.