Seghieri, Giuseppe and De Bellis, A. and Anichini, Roberto and Alviggi, L. and Franconi, Flavia and Breschi, M. C. (2005) Does parity increase insulin resistance during pregnancy? Diabetic Medicine, Vol. 22 (11), p. 1574-1580. eISSN 1464-5491. Article.
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Aims: To study the effect of parity on impairment of insulin sensitivity during pregnancy and on the risk of gestational diabetes (GDM) Methods: We studied the relationship between parity and peripheral insulin sensitivity index (ISIOGTT) or GDM in 1880 caucasian women, who underwent a 100-g, 3-h oral glucose tolerance test (OGTT) between the 24th and 28th gestational week and in 75 women who underwent an OGTT in two consecutive pregnancies. A proxy for β-cell function (basal plasma C peptide/fasting plasma glucose; CP/FPG) was also measured. Results: By univariate analysis parity was related to decreased ISIOGTT and to increased CP/FPG in those with parity > 3 and likewise GDM, diagnosed in 124 women (6.58%), was linearly related to parity (P = 0.0034) and strongly age dependent. The relationships between parity and ISIOGTT, CP/FPG and GDM were no longer significant after adjustment for age, pregestational body mass index (BMI), and weight gain. GDM was significantly related to age and pregestational weight, while ISIOGTT and CP/FPG were inversely related to prepregnancy BMI or weight gain. In comparison with the index pregnancy, the subsequent pregnancy was characterized by an increase in actual and prepregnancy BMI, in 2 h area under curve (AUC) glucose and by a decrease in ISIOGTT (P = 0.0001). The longer the time interval between pregnancies and the higher the increment in pregestational BMI or in weight gain during the pregnancy, the greater were the ISIOGTT decrease and 2-h AUC glucose increase. Conclusions: Parity is not directly linked to insulin sensitivity deterioration, to CP/FPG increase during pregnancy, or to GDM appearance, although it is linked through the mediation of progressive ageing and weight gain either before or during pregnancy, when there is a sufficiently long time interval between pregnancies.
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