Intermediate hyperglycemia in early pregnancy: A South Asian perspective

Punnose, John; Sukhija, Komal; Rijhwani, Rashika M.

doi:10.4239/wjd.v14.i5.573

Cited by 3 publications

(1 citation statement)

References 59 publications

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“…Even though not validated for use before 24 gestational weeks (GW), the oral glucose tolerance test (OGTT) is often used in South Asia to diagnose GDM in early pregnancy [22,23]. This strategy identi ed early-onset 'hyperglycemia' in 15-70% of GDM women of South Asian ethnicity, and such hyperglycemia was associated with a signi cantly increased risk for adverse pregnancy outcomes [24,25,26,27].…”

Section: Introductionmentioning

confidence: 99%

Despite treatment, HbA1c > 37mmol/mol in the first trimester is associated with premature delivery among South Asian women with gestational diabetes mellitus: a retrospective cohort study

Punnose,

Malhotra,

Sukhija

et al. 2023

Preprint

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Purpose: To examine the effects of first-trimester HbA1c (HbA1c-FT) >37mmol/mol on preterm birth (PTB) and large-for-gestational-age (LGA) babies in a retrospective cohort of South Asian pregnant women with gestational diabetes (GDM). Methods: The cohort (n = 686) was separated into two groups based on HbA1c-FT values: Group A (n=97) and Group B (n=589), with values of 37-46 mmol/mol (5.5-6.4%) and <37 mmol/mol (5.5%), respectively. HbA1c-FT's independent influence on PTB and LGA babies was examined using multivariable logistic regression in groups A and B women. The reference group (Group C) included 2031 non-GDM women with HbA1c-FT <37 mmol/mol (<5.5%). The effects of HbA1c-FT on PTB and LGA babies in obese women in Groups A, B, and C (designated as A-ob, B-ob, and C-ob, respectively) were re-analyzed using multivariable logistic regression. Results: Group A GDM women with greater HbA1c-FT had a higher risk for PTB (aOR: 1.90, 95% CI: 1.12 to 3.20) but not LGA babies (aOR: 1.20, 95%: 0.74 to 1.95). The risk of PTB was higher for obese women in Group A-ob: aOR 3.15 [95% CI 1.62 to 6.15]. However, GDM women with normal HbA1c-FT exhibited no elevated risk for PTB: Groups B and B-ob had aORs of 1.17.(95% CI 0.89 to 1.55) and 1.29 (95% CI 0.84 to 1.97) respectively. Conclusions: South Asian GDM women with prediabetic HbA1c FT; 37-46 mmol/mol (5.5-6.4%) are more likely to deliver preterm babies despite treatment, while the risk for LGA babies was the same as non-GDM women.

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Section: Introductionmentioning

confidence: 99%

Despite treatment, HbA1c > 37mmol/mol in the first trimester is associated with premature delivery among South Asian women with gestational diabetes mellitus: a retrospective cohort study

Punnose,

Malhotra,

Sukhija

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

Despite treatment, HbA1c ≥ 37 mmol/mol in the first trimester is associated with premature delivery among South Asian women with gestational diabetes mellitus: a retrospective cohort study

Punnose,

Malhotra,

Sukhija

et al. 2024

Arch Gynecol Obstet

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Earlier detection of gestational diabetes impacts on medication requirements, neonatal and maternal outcomes

Tirado‐Aguilar,

Martinez‐Cruz,

Arce‐Sanchez

et al. 2024

Diabetes Obesity Metabolism

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AimGestational diabetes (GD) is a global health concern with significant implications for maternal and neonatal outcomes. This study investigates the association between early GD (eGD) diagnosis (<24 weeks), pharmacotherapy requirements and adverse neonatal outcomes.Materials and MethodsA cohort of 369 pregnant women underwent a 75‐g oral glucose tolerance test. Maternal variables, pharmacotherapy prescriptions and neonatal outcomes were analysed employing t‐tests, χ2 tests, and logistic regression. A p < .05 was considered significant.ResultsEarly GD increased the odds of neonatal hypoglycaemia [odds ratio (OR): 18.57, p = .013] and respiratory distress syndrome (OR: 4.75, p = .034). Nutritional therapy prescription by an accredited nutritionist was the most common treatment in women diagnosed after 24 weeks, but those with eGD required more frequently specialized nutritional consulting + metformin to achieve glycaemic control (p = .027). eGD was associated with a higher requirement of nutritional therapy prescription + metformin (OR: 2.26, 95% confidence interval: 1.25‐4.09, p = .007) and with maternal hyperglycaemia during the post‐partum period at 2 h of the oral glucose tolerance test (OR: 1.03, 95% confidence interval: 1.02‐1.13, p = .024).ConclusionTimely diagnosis and personalized treatment of GD are desirable because an earlier presentation is related to a higher risk of adverse neonatal and maternal outcomes.

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Intermediate hyperglycemia in early pregnancy: A South Asian perspective

Cited by 3 publications

References 59 publications

Despite treatment, HbA1c > 37mmol/mol in the first trimester is associated with premature delivery among South Asian women with gestational diabetes mellitus: a retrospective cohort study

Despite treatment, HbA1c > 37mmol/mol in the first trimester is associated with premature delivery among South Asian women with gestational diabetes mellitus: a retrospective cohort study

Despite treatment, HbA1c ≥ 37 mmol/mol in the first trimester is associated with premature delivery among South Asian women with gestational diabetes mellitus: a retrospective cohort study

Earlier detection of gestational diabetes impacts on medication requirements, neonatal and maternal outcomes

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Intermediate hyperglycemia in early pregnancy: A South Asian perspective

Cited by 3 publications

References 59 publications

Despite treatment, HbA1c &gt; 37mmol/mol in the first trimester is associated with premature delivery among South Asian women with gestational diabetes mellitus: a retrospective cohort study

Despite treatment, HbA1c &gt; 37mmol/mol in the first trimester is associated with premature delivery among South Asian women with gestational diabetes mellitus: a retrospective cohort study

Despite treatment, HbA1c ≥ 37 mmol/mol in the first trimester is associated with premature delivery among South Asian women with gestational diabetes mellitus: a retrospective cohort study

Earlier detection of gestational diabetes impacts on medication requirements, neonatal and maternal outcomes

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Despite treatment, HbA1c > 37mmol/mol in the first trimester is associated with premature delivery among South Asian women with gestational diabetes mellitus: a retrospective cohort study

Despite treatment, HbA1c > 37mmol/mol in the first trimester is associated with premature delivery among South Asian women with gestational diabetes mellitus: a retrospective cohort study