Observations of the Effects of Maternal Fasting Plasma Glucose Changes in Early Pregnancy on Fetal Growth Profiles and Birth Outcomes

Abstract

IntroductionAlthough the role of maternal hyperglycemia on birth outcomes is clear, literature regarding fetal growth is scarce. We examined the possible associations between maternal fasting plasma glucose (FPG) and fetal growth.Materials and MethodsA total of 35,981 singleton-pregnant women with FPG in the first trimester were included. Fetal growth parameters were measured during pregnancy by ultrasound at mid and late pregnancy. Information on birth characteristics was retrieved from medical records. We used multivariable linear and logistic regression to determine the associations between FPG and z-scores of fetal parameters and risks of birth outcomes and to assess effect modification by maternal characteristics.ResultsA per-unit increase in FPG levels was negatively associated with fetal parameters in mid pregnancy but positively correlated with those in late pregnancy and with birth characteristics. The effect estimates in late pregnancy were attenuated by maternal pre-pregnancy body mass index (BMI). A significant relationship between FPG and abdominal circumference (AC), an indicator of fetal adiposity, was sustained in subgroups of women with advanced age, positive family history of diabetes, and multiparity in fully adjusted models. After stratification by BMI, high FPG was associated with accelerated AC only in normal controls (0.044 SD; 95% CI: 0.010, 0.079) and overweight/obese women (0.069 SD; 95% CI: -0.002, 0.140) but not in underweight women. High FPG was an independent risk factor for large-for-gestational age in the whole group and stratified subgroups.ConclusionsIncreased FPG in early pregnancy is closely related to fetal growth. Maternal characteristics may modify the associations between FPG and fetal adiposity in late pregnancy.

Maternal Fasting Blood Glucose, Blood Pressure, and Amniotic Fluid Volume with Baby Birth Length and Weight

“…Kadar glukosa darah puasa sendiri yang pernah diteliti berhubungan dengan pertumbuhan janin melalui mekanisme yang berbeda. Penelitian (Guo et al, 2021) mengungkapkan bahwa kadar glukosa darah puasa pada trimester awal kehamilan berkorelasi negatif dengan parameter pertumbuhan bayi saat pertengahan kehamilan, akan tetapi berhubungan positif dengan parameter pada akhir kehamilan dan saat kelahiran. Dijelaskan dalam publikasi tersebut bahwa hal ini dimungkinkan erat berkaitan dengan mekanisme penyimpanan lemak dari glukosa (fat deposit) yang berefek pada pertumbuhan bayi di trimester ketiga.…”

Effect of Maternal Pre-Pregnancy Body Mass Index on Longitudinal Fetal Growth and Mediating Role of Maternal Fasting Plasma Glucose: A Retrospective Cohort Study

“…[11][12][13] It has been reported that abnormal glucose metabolism during early pregnancy affected fetal growth, altering the trajectory of intrauterine growth, suggesting that plasma glucose may be a mediator in the association between pre-pregnancy weight and the change in fetal growth. 14,15 Therefore, we hypothesized that the association between pre-pregnancy BMI and fetal intrauterine growth in pregnant women was partly mediated by maternal early pregnancy fasting plasma glucose (FPG).…”

Pregnancy-Specific Beta-1-Glycoprotein: The Player of the Game in predicting adverse outcomes in pregnancy

“…For example, basic hematological parameters such as fasting plasma glucose and lipid profile are not mentioned in the methodology. However, it has been shown that fasting blood glucose and maternal lipid profile are associated with fetal growth retardation in the absence of chronic disease ( Guo et al ., 2021 ; Alahakoon et al ., 2020 ). Were these parameters evaluated between groups in the study?…”