{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:27:49Z","timestamp":1760059669130,"version":"build-2065373602"},"reference-count":46,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T00:00:00Z","timestamp":1750982400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Union Horizon 2020 grant","award":["847984","APP1194234"],"award-info":[{"award-number":["847984","APP1194234"]}]},{"name":"National Health and Medical Research Council, Australia","award":["847984","APP1194234"],"award-info":[{"award-number":["847984","APP1194234"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Gestational diabetes mellitus (GDM) is a growing global health concern due to its impact on maternal and infant health. GDM risk factors vary across populations, but international comparisons using standardised assessment tools are lacking. This study aimed to examine variations in risk factors, demographics and health behaviours among pregnant women at increased risk of GDM across four international sites and to investigate factors associated with maternal body mass index (BMI), a modifiable risk factor for GDM. This cross-sectional study included data from 804 pregnant women in Dublin (n = 213), Bristol (n = 205), Granada (n = 211) and Melbourne (n = 175) identified as having an increased risk of GDM, using the Monash GDM screening tool. Between-site differences were analysed using analysis of variance, Kruskal\u2013Wallis and chi-square tests and factors associated with BMI at each site were examined using multiple linear regression. Despite standardised risk screening, significant heterogeneity was observed between sites in key GDM risk factors, including age (mean range 33.8\u201336.7 years), BMI (Melbourne 28.9 vs. Granada 26.9 kg\/m2), physical activity (34.86\u201341.77 METs\/week) and dietary intake (mean energy 1881\u20132136 kcal\/day). Multiple factors were independently associated with BMI, including education level, ethnicity, health literacy and energy intake, with patterns varying by site. This study challenges the concept of a homogeneous \u201chigh-risk\u201d GDM population by revealing substantial variations in risk factors and characteristics across different patient cohorts, highlighting the importance of developing context-sensitive approaches to GDM prevention.<\/jats:p>","DOI":"10.3390\/ijerph22071022","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T03:54:28Z","timestamp":1751255668000},"page":"1022","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and Behavioural Heterogeneity Among Women at Increased Risk for Gestational Diabetes: A Four-Country Analysis"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3547-6634","authenticated-orcid":false,"given":"Sharleen L.","family":"O\u2019Reilly","sequence":"first","affiliation":[{"name":"School of Agriculture and Food Science, University College Dublin, D04 V1W8 Dublin, Ireland"},{"name":"UCD Perinatal Research Centre, School of Medicine, University College Dublin and National Maternity Hospital, D02 YH21 Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7661-0620","authenticated-orcid":false,"given":"Ellen","family":"Greene","sequence":"additional","affiliation":[{"name":"School of Agriculture and Food Science, University College Dublin, D04 V1W8 Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3477-6494","authenticated-orcid":false,"given":"Fionnuala M.","family":"McAuliffe","sequence":"additional","affiliation":[{"name":"UCD Perinatal Research Centre, School of Medicine, University College Dublin and National Maternity Hospital, D02 YH21 Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7609-577X","authenticated-orcid":false,"given":"Helena","family":"Teede","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne 3800, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9860-6785","authenticated-orcid":false,"given":"Cristina","family":"Campoy","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine, University of Granada, 18012 Granada, Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria ibs.GRANADA, Health Sciences Technological Park, 18012 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christy","family":"Burden","sequence":"additional","affiliation":[{"name":"Academic Women\u2019s Health Unit, Bristol Medical School, University of Bristol, Bristol BS8 1QU, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aisling","family":"Geraghty","sequence":"additional","affiliation":[{"name":"School of Agriculture and Food Science, University College Dublin, D04 V1W8 Dublin, Ireland"},{"name":"UCD Perinatal Research Centre, School of Medicine, University College Dublin and National Maternity Hospital, D02 YH21 Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2643-5956","authenticated-orcid":false,"given":"Mercedes G.","family":"Berm\u00fadez","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine, University of Granada, 18012 Granada, Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria ibs.GRANADA, Health Sciences Technological Park, 18012 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0743-6547","authenticated-orcid":false,"given":"Anna","family":"Davies","sequence":"additional","affiliation":[{"name":"Academic Women\u2019s Health Unit, Bristol Medical School, University of Bristol, Bristol BS8 1QU, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3154-4946","authenticated-orcid":false,"given":"Cheryce L.","family":"Harrison","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne 3800, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helle","family":"Terkildsen Maindal","sequence":"additional","affiliation":[{"name":"Department of Public Health, Aarhus University, 8000 Aarhus, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8514-1763","authenticated-orcid":false,"given":"Vincent L.","family":"Versace","sequence":"additional","affiliation":[{"name":"Deakin Rural Health, Faculty of Health, Deakin University, Geelong 3220, Australia"},{"name":"GeoHealth Laboratory, Dasman Diabetes Institute, Kuwait City 15462, Kuwait"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7011-9996","authenticated-orcid":false,"given":"Ditte Hjorth","family":"Laursen","sequence":"additional","affiliation":[{"name":"Liva Healthcare, 1434 Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0018-6963","authenticated-orcid":false,"given":"Timothy","family":"Skinner","sequence":"additional","affiliation":[{"name":"School of Psychology, Faculty of Health, Deakin University, Geelong 3200, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the IMPACT DIABETES B2B Collaboration Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"109050","DOI":"10.1016\/j.diabres.2021.109050","article-title":"IDF Diabetes Atlas: Estimation of Global and Regional Gestational Diabetes Mellitus Prevalence for 2021 by International Association of Diabetes in Pregnancy Study Group\u2019s Criteria","volume":"183","author":"Wang","year":"2022","journal-title":"Diabetes Res. 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