Association of Parity With Insulin Resistance Early in Pregnant Women: ECLIPSES Study

Identificador:  imarina:9330535

Handle: https://hdl.handle.net/20.500.11797/imarina9330535

Autores:  Motevalizadeh, E; Díaz-López, A; Martín, F; Basora, J; Arija, V

Resumen:
Little is known about whether parity is associated with elevated early-pregnancy IR, or whether overweight/obesity contributes to increasing the possible effect.We determined the associations between parity and glucose metabolism parameters in the first trimester of pregnancy in a Mediterranean pregnant population, and whether these associations are impacted by overweight/obesity.Cross-sectional study of 264 healthy pregnant women from the ECLIPSES study who were recruited at 12 weeks of gestation. At baseline, details on socio-economic status, obstetric history (including parity, i.e., number of births), lifestyle factors, anthropometry, and blood samples were collected. Fasting serum glucose, insulin, and HOMA-IR index were assessed in the first trimester. Elevated IR was defined as the upper HOMA-IR tertile (≥1.58). Multivariable linear regression and Cox regression model with constant time were performed.Parity ranged from 0-4. After multivariable adjustment, the insulin levels (β (% change): 20.92, 95%CI: 4.08, 37.71) and HOMA-IR index (β (% change): 19.72, 95%CI: 2.43, 40.49) were positively associated with parity. Additionally, multiparous women, as compared to nulliparous, were more likely to have higher HOMA-IR levels (primiparous (one birth), β (% change): 16.88, 95%CI: -1.00, 37.99; multiparous (≥2 two births), β (% change): 32.18, 95%CI: 3.56, 68.71), and an increased relative risk (RR) of an elevated IR (primiparous (one birth), RR: 1.55, 95%CI: 1.03, 2.36; multiparous (≥2 two births), RR: 1.72, 95%CI: 1.05, 2.83). The combination of multiparity and overweight/obesity conferred a 3.04-fold increase in the RR of elevated IR, which increased proportionally to the number of parities.This study demonstrates that parity may have a negative impact on early-pregnancy IR and that maternal overweight/obesity appears to further aggravate this relationship.© The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.