Association between gestational abnormal glucose tolerance and maternal‐fetal outcomes

Kung, Wan‐Ju; Kuo, Hsin-Yi; Lee, Chien-Hung; Zen, Yeong-Hwa; Kong, Li-Chin; Lin, Ching‐Chiang

doi:10.1111/jog.15350

Cited by 7 publications

(3 citation statements)

References 41 publications

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“…Smaller retrospective cohort studies of pregnant individuals with gestational glucose intolerance also report increased risk of macrosomia and larger birth weight. 14,15,33,34 A meta-analysis including cohorts from a wide time period , with heterogeneity of GDM diagnostic criteria and available outcomes, had results consistent with ours. 35 Although this study showed increased risk of LGA and cesarean deliveries, it did not examine additional rarer birth weight-related adverse perinatal outcome included in our study.…”

Section: Be Valuable In Clinical Decision Making About Perinatal Risksupporting

confidence: 82%

“…Previous studies examining the risk of cesarean deliveries in this population are largely consistent with our findings, 15,33,35 but there are some mixed data. 34 We found that the odds of severe perineal lacerations were higher in pregnant individuals with gestational glucose intolerance with one abnormal OGTT value but not in those with GDM; this may be related to lack of glucose-lowering treatment and lack of indicated delivery before 40 weeks of gestation in pregnant individuals with gestational glucose intolerance, leading to greater absolute birth weight, 5,9 because higher birth weight is a known risk factor for perineal trauma. To the best of our knowledge, other studies have not reported a positive association between gestational glucose intolerance and severe perineal lacerations; a previous negative retrospective study was likely underpowered.…”

Section: Be Valuable In Clinical Decision Making About Perinatal Riskmentioning

confidence: 88%

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Gestational Glucose Intolerance and Birth Weight–Related Complications

Maya,

Selen,

Thaweethai

et al. 2023

Obstetrics &Amp; Gynecology

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OBJECTIVE: To evaluate the risks of large-for-gestational-age birth weight (LGA) and birth weight–related complications in pregnant individuals with gestational glucose intolerance, an abnormal screening glucose loading test result without meeting gestational diabetes mellitus (GDM) criteria. METHODS: In a retrospective cohort study of 46,989 individuals with singleton pregnancies who delivered after 28 weeks of gestation, those with glucose loading test results less than 140 mg/dL were classified as having normal glucose tolerance. Those with glucose loading test results of 140 mg/dL or higher and fewer than two abnormal values on a 3-hour 100-g oral glucose tolerance test (OGTT) were classified as having gestational glucose intolerance. Those with two or more abnormal OGTT values were classified as having GDM. We hypothesized that gestational glucose intolerance would be associated with higher odds of LGA (birth weight greater than the 90th percentile for gestational age and sex). We used generalized estimating equations to examine the odds of LGA in pregnant individuals with gestational glucose intolerance compared with those with normal glucose tolerance, after adjustment for age, body mass index, parity, health insurance, race and ethnicity, and marital status. In addition, we investigated differences in birth weight–related adverse pregnancy outcomes. RESULTS: Large for gestational age was present in 7.8% of 39,685 pregnant individuals with normal glucose tolerance, 9.5% of 4,155 pregnant individuals with gestational glucose intolerance and normal OGTT, 14.5% of 1,438 pregnant individuals with gestational glucose intolerance and one abnormal OGTT value, and 16.0% of 1,711 pregnant individuals with GDM. The adjusted odds of LGA were higher in pregnant individuals with gestational glucose intolerance than in those with normal glucose tolerance overall (adjusted odds ratio [aOR] 1.35, 95% CI 1.23–1.49, P<.001). When compared separately with pregnant individuals with normal glucose tolerance, those with either gestational glucose intolerance subtype had higher adjusted LGA odds (gestational glucose intolerance with normal OGTT aOR 1.21, 95% CI 1.08–1.35, P<.001; gestational glucose intolerance with one abnormal OGTT value aOR 1.77, 95% CI 1.52–2.08, P<.001). The odds of birth weight–related adverse outcomes (including cesarean delivery, severe perineal lacerations, and shoulder dystocia or clavicular fracture) were higher in pregnant individuals with gestational glucose intolerance with one abnormal OGTT value than in those with normal glucose tolerance. CONCLUSION: Gestational glucose intolerance in pregnancy is associated with birth weight–related adverse pregnancy outcomes. Glucose lowering should be investigated as a strategy for lowering the risk of these outcomes in this group.

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Section: Be Valuable In Clinical Decision Making About Perinatal Risksupporting

confidence: 82%

Section: Be Valuable In Clinical Decision Making About Perinatal Riskmentioning

confidence: 88%

Gestational Glucose Intolerance and Birth Weight–Related Complications

Maya,

Selen,

Thaweethai

et al. 2023

Obstetrics &Amp; Gynecology

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“…Indeed, independently of other known risk factors for GDM, ultrasound-estimated maternal visceral adipose tissue (VAT) thickness in pregnancy is strongly associated with insulin resistance and higher risks of developing GDM [ 2 , 3 , 4 , 5 ]. Along with increased adiposity, GDM can have detrimental health consequences for both the mother and the fetus [ 6 , 7 , 8 , 9 ]. Hence, glycemic control is particularly fundamental in all pregnant individuals (with or without GDM), as continuous associations between maternal glucose levels (below those of GDM diagnosis) and adverse pregnancy outcomes, such as primary cesarean delivery and neonatal hypoglycemia, have been observed [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Trimester-Specific Serum Fructosamine in Association with Abdominal Adiposity, Insulin Resistance, and Inflammation in Healthy Pregnant Individuals

et al. 2022

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This study aimed to (1) characterize the variations in serum fructosamine across trimesters and according to pre-pregnancy BMI (ppBMI), and (2) examine associations between fructosamine and adiposity/metabolic markers (ppBMI, first-trimester adiposity, leptin, glucose homeostasis, and inflammation measurements) during pregnancy. Serum fructosamine, albumin, fasting glucose and insulin, leptin, adiponectin, interleukin-6 (IL-6), and C-reactive protein (CRP) concentrations were measured at each trimester. In the first trimester, subcutaneous (SAT) and visceral (VAT) adipose tissue thicknesses were estimated by ultrasound. In the 101 healthy pregnant individuals included (age: 32.2 ± 3.5 y.o.; ppBMI: 25.5 ± 5.5 kg/m2), fructosamine concentrations decreased during pregnancy whereas albumin-corrected fructosamine concentrations increased (p < 0.0001 for both). Notably, fructosamine concentrations were inversely associated with ppBMI, first-trimester SAT, VAT, and leptin (r = −0.55, r = −0.61, r = −0.48, r = −0.47, respectively; p < 0.0001 for all), first-trimester fasting insulin and HOMA-IR (r = −0.46, r = −0.46; p < 0.0001 for both), and first-trimester IL-6 (r = −0.38, p < 0.01). However, once corrected for albumin, most of the correlations lost strength. Once adjusted for ppBMI, fructosamine concentrations were positively associated with third-trimester fasting glucose and CRP (r = 0.24, r = 0.27; p < 0.05 for both). In conclusion, serum fructosamine is inversely associated with adiposity before and during pregnancy, with markers of glucose homeostasis and inflammation, but the latter associations are partially influenced by albumin concentrations and ppBMI.

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