G Sesmilo1, P Prats2, S Garcia2, I Rodríguez2, A Rodríguez-Melcón2, I Berges3, B Serra2. 1. Endocrine Unit, Hospital Universitari Quirón-Dexeus, C/Sabino de Arana 5-19, 08028, Barcelona, Spain. 30064gsl@comb.cat. 2. Obstetrical, Gynecologic and Reproductive Unit, Hospital Universitari Quirón-Dexeus, C/Sabino de Arana 5-19, 08028, Barcelona, Spain. 3. Endocrine Unit, Hospital Universitari Quirón-Dexeus, C/Sabino de Arana 5-19, 08028, Barcelona, Spain.
Abstract
AIMS: Studies to prevent gestational diabetes (GDM) have shown the best results when lifestyle measures have been applied early in pregnancy. We aimed to investigate whether first-trimester fasting plasma glucose (FPG) could predict GDM risk and adverse pregnancy outcomes. METHODS: A retrospective analysis of prospectively collected data from singleton pregnancies who were attended at our hospital between 2008 and 2018 (n = 27,198) was performed. We included patients with a recorded first-trimester FPG and complete pregnancy data (n = 6845). Patients under 18, with pregestational diabetes or reproductive techniques, were excluded. First-trimester FPG was evaluated as a continuous variable and divided into quartiles. GDM was diagnosed by NDDG criteria. The relationship between first- and second-trimester glucose > 92 mg/dL was also investigated. The relationship between FPG and pregnancy outcomes was assessed in 6150 patients who did not have GDM. RESULTS: Maternal age was 34.2 ± 3.9 years, BMI 23.1 ± 3.7 kg/m2 and mean FPG 83.0 ± 7.3 mg/dL. Glucose quartiles were: ≤ 78, 79-83, 84-87 and ≥ 88 mg/dL. First-trimester FPG predicted the risk of GDM (7%, 8%, 10.2% and 16% in each quartile, p < 0.001) and the risk of second-trimester glucose > 92 mg/dL (2.6%, 3.8%, 6.3% and 11.4% in each quartile, p < 0.001). FPG was significantly associated with LGA (8.2%, 9.3%, 10% and 11.7% in each quartile, p = 0.011) but not with other obstetrical outcomes. In a multivariate analysis including age, BMI, tobacco use, number of pregnancies and weight gained during pregnancy, first-trimester FPG was an independent predictor of LGA. CONCLUSIONS: First-trimester FPG is an early marker of GDM and LGA.
AIMS: Studies to prevent gestational diabetes (GDM) have shown the best results when lifestyle measures have been applied early in pregnancy. We aimed to investigate whether first-trimester fasting plasma glucose (FPG) could predict GDM risk and adverse pregnancy outcomes. METHODS: A retrospective analysis of prospectively collected data from singleton pregnancies who were attended at our hospital between 2008 and 2018 (n = 27,198) was performed. We included patients with a recorded first-trimester FPG and complete pregnancy data (n = 6845). Patients under 18, with pregestational diabetes or reproductive techniques, were excluded. First-trimester FPG was evaluated as a continuous variable and divided into quartiles. GDM was diagnosed by NDDG criteria. The relationship between first- and second-trimester glucose > 92 mg/dL was also investigated. The relationship between FPG and pregnancy outcomes was assessed in 6150 patients who did not have GDM. RESULTS: Maternal age was 34.2 ± 3.9 years, BMI 23.1 ± 3.7 kg/m2 and mean FPG 83.0 ± 7.3 mg/dL. Glucose quartiles were: ≤ 78, 79-83, 84-87 and ≥ 88 mg/dL. First-trimester FPG predicted the risk of GDM (7%, 8%, 10.2% and 16% in each quartile, p < 0.001) and the risk of second-trimester glucose > 92 mg/dL (2.6%, 3.8%, 6.3% and 11.4% in each quartile, p < 0.001). FPG was significantly associated with LGA (8.2%, 9.3%, 10% and 11.7% in each quartile, p = 0.011) but not with other obstetrical outcomes. In a multivariate analysis including age, BMI, tobacco use, number of pregnancies and weight gained during pregnancy, first-trimester FPG was an independent predictor of LGA. CONCLUSIONS: First-trimester FPG is an early marker of GDM and LGA.
Authors: Saila B Koivusalo; Kristiina Rönö; Miira M Klemetti; Risto P Roine; Jaana Lindström; Maijaliisa Erkkola; Risto J Kaaja; Maritta Pöyhönen-Alho; Aila Tiitinen; Emilia Huvinen; Sture Andersson; Hannele Laivuori; Anita Valkama; Jelena Meinilä; Hannu Kautiainen; Johan G Eriksson; Beata Stach-Lempinen Journal: Diabetes Care Date: 2015-07-29 Impact factor: 19.112
Authors: Alejandra Duran; Sofía Sáenz; María J Torrejón; Elena Bordiú; Laura Del Valle; Mercedes Galindo; Noelia Perez; Miguel A Herraiz; Nuria Izquierdo; Miguel A Rubio; Isabelle Runkle; Natalia Pérez-Ferre; Idalia Cusihuallpa; Sandra Jiménez; Nuria García de la Torre; María D Fernández; Carmen Montañez; Cristina Familiar; Alfonso L Calle-Pascual Journal: Diabetes Care Date: 2014-06-19 Impact factor: 19.112
Authors: Lucilla Poston; Ruth Bell; Helen Croker; Angela C Flynn; Keith M Godfrey; Louise Goff; Louise Hayes; Nina Khazaezadeh; Scott M Nelson; Eugene Oteng-Ntim; Dharmintra Pasupathy; Nashita Patel; Stephen C Robson; Jane Sandall; Thomas A B Sanders; Naveed Sattar; Paul T Seed; Jane Wardle; Melissa K Whitworth; Annette L Briley Journal: Lancet Diabetes Endocrinol Date: 2015-07-09 Impact factor: 32.069
Authors: Carolyn Chiswick; Rebecca M Reynolds; Fiona Denison; Amanda J Drake; Shareen Forbes; David E Newby; Brian R Walker; Siobhan Quenby; Susan Wray; Andrew Weeks; Hany Lashen; Aryelly Rodriguez; Gordon Murray; Sonia Whyte; Jane E Norman Journal: Lancet Diabetes Endocrinol Date: 2015-07-09 Impact factor: 32.069
Authors: Emily W Harville; Carrie E Crook; Lydia A Bazzano; Jessica G Woo; Trudy L Burns; Olli Raitakari; Elaine M Urbina; Alison Venn; David R Jacobs; Julia Steinberger; Alan Sinaiko; Terence Dwyer; Markus Juonala Journal: J Obstet Gynaecol Res Date: 2021-09-05 Impact factor: 1.730