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EB Research - Perinatal Epidemiology
Gestational Diabetes Mellitus - Epidemiology, Etiology, and Health Consequences
Gestational diabetes mellitus (GDM), one of the most common complications of pregnancy, is related to substantial short-term and long-term adverse health outcomes for both women and their offspring. Understanding the epidemiology and etiology of GDM is critical for the development of effective and targeted intervention strategies to prevent GDM and to interrupt the vicious cycle across generations involving maternal GDM, childhood obesity and impaired glucose metabolism, and adulthood onset diabetes. Along this line of research, a series of studies have been conducted and are under study. These include:
- Identification of risk factors, for instance, diet and lifestyle factors, reproductive factors, early life risk factors, and genetic factors, for the development of GDM and its recurrence. In collaboration with investigators at the Harvard School of Public Health and other institutes, a number of novel risk factors have been identified and additional risk factors are currently under study based on data from the Nurses’ Health Study II.
- Investigation of the pathogenesis of GDM using prospectively and longitudinally collected biospecimens from pregnancy cohorts, such as the NICHD Fetal Growth Study and the EAGeR Study. Currently, this line of research focuses on a comprehensive panel of biochemical markers that are putatively implicated in glucose homeostasis, fetal growth, or both. Targeted and non-targeted metabolomics will also be analyzed for the discovery of new pathways and/or biochemical markers related to glucose intolerance and subsequent adverse fetal outcomes.
- Investigation of the impact and underlying mechanisms of how a hyperglycemic intrauterine environment affects short-term and long-term health outcomes in the offspring based on multiple datasets, for instance, the Diabetes & Women’s Health Study and the Safe Labor Consortium.
Cuilin Zhang, M.D., M.P.H., Ph.D.
- Katherine Bowers, Ph.D., Cincinnati Children’s Hospital Medical Center
- Frank Hu, M.D., Ph.D., and Deirdre Tobias, Ph.D., Harvard School of Public Health
- Mike Tsai, M.D., Ph.D., Advanced Research and Diagnostic Laboratory, University of Minnesota
- Zhang C, Ning Y. Effect of dietary and lifestyle factors on the risk of gestational diabetes: review of epidemiologic evidence. Am J Clin Nutr. 2011;94(6 Suppl):1975S-1979S. PMID: 21613563
- Bowers K, Tobias DK, Yeung E, Hu FB, Zhang C. A prospective study of prepregnancy dietary fat intake and risk of gestational diabetes. Am J Clin Nutr. 2012;95(2):446-453. PMID: 22218158
- Chen L, Hu FB, Yeung E, Tobias DK, Willett WC, Zhang C. Prepregnancy consumption of fruits and fruit juices and the risk of gestational diabetes mellitus: a prospective cohort study. Diabetes Care. 2012;35(5):1079-1082. PMID: 22446174
- Tobias DK, Zhang C, Chavarro J, Bowers K, Rich-Edwards J, Rosner B, Mozaffarian D, Hu FB. Prepregnancy adherence to dietary patterns and lower risk of gestational diabetes mellitus. Am J Clin Nutr. 2012;96(2):289-295. PMID: 22760563
- Tobias DK, Zhang C, van Dam RM, Bowers K, Hu FB. Physical activity before and during pregnancy and risk of gestational diabetes mellitus: a meta-analysis. Diabetes Care. 2011;34(1):223-229. PMID: 20876206
- Bowers K, Yeung E, Williams MA, Qi L, Tobias DK, Hu FB, Zhang C. A prospective study of prepregnancy dietary iron intake and risk for gestational diabetes mellitus. Diabetes Care. 2011;34(7):1557-1563. PMID: 21709294
- Yeung EH, Hu FB, Solomon CG, Chen L, Louis GM, Schisterman E, Willett WC, Zhang C. Life-course weight characteristics and the risk of gestational diabetes. Diabetologia. 2010;53(4):668-678. PMID: 20043144
- Chen L, Hu FB, Yeung E, Willett W, Zhang C. Prospective study of pre-gravid sugar-sweetened beverage consumption and the risk of gestational diabetes mellitus. Diabetes Care. 2009;32(12):2236-2241. PMID: 19940226
- Zhang C, Solomon CG, Manson JE, Hu FB. A prospective study of pregravid physical activity and sedentary behaviors in relation to the risk for gestational diabetes mellitus. Arch Intern Med. 2006;166(5):543-548. PMID: 16534041
- Zhang C, Liu S, Solomon CG, Hu FB. Dietary fiber intake, dietary glycemic load, and the risk for gestational diabetes mellitus. Diabetes Care. 2006;29(10):2223-2230. PMID: 17003297
- Zhang C, Schulze MB, Solomon CG, Hu FB. A prospective study of dietary patterns, meat intake and the risk of gestational diabetes mellitus. Diabetologia. 2006;49(11):2604-2613. PMID: 16957814