Association between maternal glucose levels during pregnancy and gestational diabetes mellitus: an analytical cross-sectional study

Abstract

BackgroundTo evaluate the association between fasting glucose levels in women throughout pregnancy and the occurrence of gestational diabetes mellitus (GDM) and other pregnancy complications, macrosomia, and cesarean delivery.MethodsAn analytical cross-sectional study with 829 healthy pregnant women receiving health care at a public maternity unit in Rio de Janeiro between 1999 and 2008. The dependent variables assessed in the study were: GDM (was confirmed when two or more values were above the glucose curve using 100 g glucose), complications, mode of delivery and birth weight. Macrosomia was defined as a birth weight of >4000 g. The independent variables assessed were: maternal fasting glucose per trimester as a continuous variable, divided into three categories, socio-demographic data on the mothers. The level of statistical significance was set at 5%.ResultsThe mean fasting glucose levels of the women who had GDM were higher in the second trimester than for those who had no pregnancy complications (90.5 mg/dL vs. 78.5 mg/dL, p = 0.000). Higher mean fasting glucose levels were also found in the third trimester for women who developed GDM than for those with no pregnancy complications (90 mg/dL vs. 77.8 mg/dL, p = 0.016). Women who had a cesarean delivery had higher fasting glucose levels in the second (80.4 mg/dL vs. 78 mg/dL, post hoc = 0.034) and third (80.4 mg/dL and 77.1 mg/dL; post hoc = 0.005) trimesters than women who had a normal delivery. Also, higher fasting glucose levels were found in the second semester for women whose infants had macrosomia than for women whose newborns were normal weight (86.2 mg/dL and 78.8 mg/dL; post hoc = 0.003). The chance of develop GDM was higher for the women with glucose levels in the 90–94 mg/dL range in the second trimester (OR = 7.2; 95% CI = 2.33-22.24) than for the women whose glucose levels were in the <80 mg/dL and 80-90 mg/dL ranges.ConclusionSecond and third trimester fasting glucose levels below the cut-off values for the diagnosis of GDM are associated with an increased risk of pregnancy complications. The dependent variables assessed in the study were: GDM (present/absent), complications, mode of delivery (normal, forceps, cesarean), and birth weight.

The diagnostic value of glycated albumin in gestational diabetes mellitus

“…Even minor elevations of glucose in pregnancy are associated with worse fetal and maternal outcomes. Seabra et al [ 25 ] performed a cross-sectional study of 829 healthy pregnant women and found that second and third trimester FPG levels below the cut-off values for a diagnosis of GDM were associated with an increased risk of pregnancy complications. In the current study, FPG provided a better diagnostic value than GA or HbA1c only at 24–28 weeks’ gestation.…”

Adverse birth outcome: a comparative analysis between cesarean section and vaginal delivery at Felegehiwot Referral Hospital, Northwest Ethiopia: a retrospective record review

“…It has long been well documented in several studies 4 – 7 , 11 , 13 that CS delivery is more associated with increased fetal complications including reduced Apgar score, respiratory distress syndrome, and neonatal transfer rate. Consistent with other studies, 10 the risk of birth asphyxia among babies born by CS was higher than those delivered vaginally.…”

“… 6 – 8 Other surveys benefit vaginal delivery because cesarean delivery has a higher risk of maternal death, 9 a longer recovery time and operative complications, 10 a higher risk of unexplained stillbirths in subsequent pregnancies, 6 and respiratory problems of the newborn infant. 11 – 13 …”

Serum Uric Acid and Plasma Glucose Levels in Normal Pregnancy

“…The International Association of Diabetes Pregnancy Study Group (IADPSG) for the diagnosis of GDM also called the 2013 WHO criteria for GDM proposed that Pregnant women with fasting plasma glucose greater than or equal to 5.1 mmol/l (92 mg/dl) but less than 7.0 mmol/l (126 mg/dl) may be diagnostic of GDM [40]. Seabra et al, observed that second and thirdtrimester fasting glucose levels of 4.47 to 5.20mmol/l were associated with an increased risk of pregnancy complications; GDM, macrosomia and cesarean section deliveries [41]. Seabra et al, concluded that the gestational periods in which maternal blood glucose had a greater influence on the appearance of complications were the second and third quarters, indicating vulnerable periods since they arerelated to intensive developmental phase and fetal growth [41].…”

“…Seabra et al, observed that second and thirdtrimester fasting glucose levels of 4.47 to 5.20mmol/l were associated with an increased risk of pregnancy complications; GDM, macrosomia and cesarean section deliveries [41]. Seabra et al, concluded that the gestational periods in which maternal blood glucose had a greater influence on the appearance of complications were the second and third quarters, indicating vulnerable periods since they arerelated to intensive developmental phase and fetal growth [41]. Hyperglycemia from any cause can seriously affect both mother and baby and could increase the risk of complications in pregnancy, labour and after delivery in conditions not monitored properly [42].…”