Early diagnosed gestational diabetes mellitus is associated with adverse pregnancy outcomes: A prospective cohort study

2021 ◽  
Author(s):  
Liu B ◽  
Cai J ◽  
Xu Y ◽  
Long Y ◽  
Deng L ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Prospective Cohort Study ◽  
Pregnancy Outcomes ◽  
Prospective Cohort ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Pregnancy

Early Diagnosed Gestational Diabetes Mellitus Is Associated With Adverse Pregnancy Outcomes: A Prospective Cohort Study

2020 ◽  
Vol 105 (12) ◽  
pp. e4264-e4274 ◽  
Author(s):  
Bin Liu ◽  
Jian Cai ◽  
Yun Xu ◽  
Yuhang Long ◽  
Langhui Deng ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Early Diagnosis ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnancy Outcomes ◽  
Early Onset ◽  
Prospective Cohort ◽  
Metabolic Disorders ◽  
Adverse Pregnancy

Abstract Context The significance of an early diagnosis of gestational diabetes mellitus (GDM) with oral glucose tolerance test (OGTT) has not been determined. Objective The objective of this work is to investigate GDM diagnosed by early and standard OGTTs and determine adverse maternal and neonatal outcomes associated with early GDM diagnosis. Research Design and Methods The Early Diagnosis of Gestational Diabetes Mellitus study is a prospective cohort study. Each participant in the study underwent 2 OGTTs, an early OGTT at 18 to 20 gestational weeks (gws) and a standard OGTT at 24 to 28 gws. The reproduciblity between early and standard OGTT were analyzed. Maternal and neonatal metabolic disorders and pregnancy outcomes were compared across groups. Results A total of 522 participants completed both the early and standard OGTTs. The glucose values in the early OGTT were not significantly different from those in the standard OGTT (fasting: 4.31 ± 0.41 mmol/L vs 4.29 ± 0.37 mmol/L, P = .360; 1-hour: 7.68 ± 1.71 mmol/L vs 7.66 ± 1.59 mmol/L, P = .826; 2-hour: 6.69 ± 1.47 mmol/L vs 6.71 ± 1.39 mmol/L, P = .800). The reproducibility of early and standard OGTT results was 74.9%. Pregnant women in the GDM group had higher glycated hemoglobin, C-peptide, and homeostasis model assessment of insulin resistance in the late gestational period. Neonates born to mothers in the GDM group were at a higher risk of being large for gestational age (odds ratio [OR]: 3.665; 95% CI, 1.006-11.91) and were also more prone to neonatal hyperinsulinemia (OR: 3.652; 95% CI, 1.152-10.533). Conclusion Early-onset GDM diagnosed by OGTT at 18 to 20 gws is associated with maternal and neonatal metabolic disorders and adverse pregnancy outcomes. Further randomized controlled trials on the therapeutic efficacy for early-onset GDM will confirm the significance of early screening for GDM.

scholarly journals First-Trimester Fasting Hyperglycemia without Gestational Diabetes Mellitus is not Associated with Adverse Pregnancy Outcomes:A Prospective Cohort Study in China

2020 ◽  
Author(s):  
Zhiheng Guo ◽  
Yanhong Shan ◽  
Caifeng Xiu ◽  
Yi Yang ◽  
Shu Zheng ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Apgar Score ◽  
Prospective Cohort ◽  
First Trimester ◽  
Adverse Pregnancy

Abstract Background Gestational diabetes mellitus (GDM) is a common pregnancy-induced metabolic complication worldwide. At present, a variety of strategies for diagnosis and management of GDM have been recommended. Our aim is to investigate the clinical features and pregnancy outcomes among women in whom a first-trimester fasting glucose value (≥ 5.10 mmol/L but < 7.0 mmol/L) was detected and a 2-h 75-g oral glucose tolerance test (OGTT) between 24–28 weeks was negative.Methods This is a prospective cohort study of women who registered and delivered between June 2016 and November 2019 at First Hospital, Jilin University. Pregnant women who met the inclusion criteria were categorized as normal first-trimester fasting plasma glucose(FPG)(< 5.10 mmol/L) and first-trimester fasting hyperglycemia (≥ 5.10 mmol/L but < 7 mmol/L).Outcomes included weeks at time of delivery, neonatal birth weight, Apgar score at 1 min, Apgar score at 5 min, prevalence of macrosomia, hypertensive disorders of pregnancy ,primary cesarean delivery, preterm delivery ,premature rupture of membranes and sillbirth or neonatal death were compared after women who developed gestational diabetes mellitus (GDM) were excluded.Results In our population of 2124 eligible subjects, pregnant women with first-trimester fasting hyperglycemia (≥ 5.10 mmol/L but < 7 mmol/L) constituted 20.8% of the total study population and accounted for 27.6% of subsequent GDM diagnosis. The other 1683 had a normal first-trimester FPG (< 5.1 mmol/L), accounting for 11.6% of all subsequent GDM diagnosis (p < 0.01).After excluding women with a diagnosis of GDM between 24 and 28 weeks of gestation, we observed no significant difference between groups for adverse maternal and prenatal outcomes.Conclusion More than two thirds of first-trimester fasting hyperglycemia pregnant women will have a normal OGTT performed at 24–28 week and of these women whom in no increased risk of adverse pregnancy outcomes have been identified.

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