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The impact of first trimester fasting glucose level on adverse perinatal outcome

Journal of Perinatology volume 38, pages 451–455 (2018)Cite this article

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Abstract

Objective

To evaluate the impact of first trimester fasting glucose (FTFG) level on perinatal outcome.

Study design

A retrospective cohort study of singleton deliveries. Maternal and neonatal outcome were compared between two groups—women with FTFG < 95 mg/dl and FTFG ≥ 95 mg/dl. Women with pre-gestational diabetes were excluded.

Results

Five thousand and thirty women met inclusion criteria. Of whom, 4644 (92.3%) had FTFG < 95 mg/dl and 386 (7.7%) had FTFG ≥ 95 mg/dl. Women with FTFG ≥ 95 mg/dl had higher rates of gestational hypertension (2.33 vs. 0.7%) and gestational diabetes (9.07 vs. 2.86%), p < 0.05 for both. Moreover, they had higher rates of cesarean delivery and arrest of descent, p < 0.05. Composite diabetes outcome was significantly higher among women with FTFG ≥ 95 mg/dl (8 vs. 3%, p = 0.002).

After adjusting for potential confounders, composite diabetes outcome (aOR = 1.942 95% CI 1.265–2.981, p = 0.002) and gestational hypertension (aOR = 2.827 95% CI 1.295–6.175, p = 0.009) remained significantly higher in the FTFG ≥ 95 mg/dl group.

Conclusion

FTFG ≥ 95 mg/dl is an independent risk factor for adverse perinatal outcome including gestational hypertension and diabetes-related complications.

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References

  1. Al Wattar BH, Tamilselvan K, Khan R, Kelso A, Sinha A, Pirie AM, et al. 2. Classification and diagnosis of diabetes. Diabetes Care. 2017;40:S11–24.

    Article  Google Scholar 

  2. Paglia MJ, Coustan DR. Committee opinion No. 504. Obstet Gynecol. 2011;118:751–3.

    Article  Google Scholar 

  3. Jacobson JD, Cousins L. A population-based study of maternal and perinatal outcome in patients with gestational diabetes. Am J Obstet Gynecol. 1989;161:981–6.

    Article  CAS  Google Scholar 

  4. Vignoles P, Gire C, Mancini J, Bretelle F, Boubli L, Janky E, et al. Gestational diabetes: a strong independent risk factor for severe neonatal respiratory failure after 34 weeks. Arch Gynecol Obstet. 2011;284:1099–104.

    Article  Google Scholar 

  5. Naylor CD, Sermer M, Chen E, Sykora K. Cesarean delivery in relation to birth weight and gestational glucose tolerance: pathophysiology or practice style? Toronto Trihospital Gestational Diabetes Investigators. JAMA. 1996;275:1165–70.

    Article  CAS  Google Scholar 

  6. Roeckner JT, Sanchez-Ramos L, Jijon-Knupp R, Kaunitz AM. Single abnormal value on 3-hour oral glucose tolerance test during pregnancy is associated with adverse maternal and neonatal outcomes: a systematic review and metaanalysis. Am J Obstet Gynecol. 2016;215:287–97.

    Article  Google Scholar 

  7. Dollberg S, Haklai Z, Mimouni FB, Gorfein I, Gordon ES. Birthweight standards in the live-born population in Israel. Isr Med Assoc J. 2005;7:311–4.

    PubMed  Google Scholar 

  8. Barquiel B, Herranz L, Grande C, Castro-Dufourny I, llaro M, Parra P, et al. Body weight, weight gain and hyperglycaemia are associated with hypertensive disorders of pregnancy in women with gestational diabetes. Diabetes Metab. 2014;40:204–10.

    Article  CAS  Google Scholar 

  9. Nerenberg K, Daskalopoulou SS, Dasgupta K. Gestational diabetes and hypertensive disorders of pregnancy as vascular risk signals: an overview and grading of the evidence. Can J Cardiol. 2014;30:765–73.

    Article  Google Scholar 

  10. Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U, Coustan DR, et al. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008;358:1991–2002.

    Article  Google Scholar 

  11. Ethridge JK, Catalano PM, Waters TP. Perinatal outcomes associated with the diagnosis of gestational diabetes made by the international association of the diabetes and pregnancy study groups criteria. Obstet Gynecol. 2014;124:571–8.

    Article  Google Scholar 

  12. Boulet SL, Alexander GR, Salihu HM, Pass M. Macrosomic births in the United States: determinants, outcomes, and proposed grades of risk. Am J Obstet Gynecol. 2003;188:1372–8.

    Article  Google Scholar 

  13. Chavkin U, Wainstock T, Sheiner E, Sergienko R, Walfisch A. Perinatal outcome of pregnancies complicates with extreme birth weights at term. J Matern Neonatal Med. 2017;19:1–15.

    Google Scholar 

  14. Bateman BT, Berman MF, Riley LE, Leffert LR. The epidemiology of postpartum hemorrhage in a large, nationwide sample of deliveries. Anesth Analg. 2010;110:1368–73.

    Article  Google Scholar 

  15. Conway DL, Langer O. Elective delivery of infants with macrosomia in diabetic women: reduced shoulder dystocia versus increased cesarean deliveries. Am J Obstet Gynecol. 1998;178:922–5.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel

    Lina Salman, Adi Borovich, Anat Shmueli, Rony Chen, Arnon Wiznitzer & Eran Hadar

  2. Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel

    Nissim Arbib

Authors
  1. Lina Salman
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  2. Nissim Arbib
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  3. Adi Borovich
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  4. Anat Shmueli
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  5. Rony Chen
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  6. Arnon Wiznitzer
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  7. Eran Hadar
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Corresponding author

Correspondence to Lina Salman.

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The authors declare that they have no conflict of interest.

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Both affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel -Aviv, Israel

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Salman, L., Arbib, N., Borovich, A. et al. The impact of first trimester fasting glucose level on adverse perinatal outcome. J Perinatol 38, 451–455 (2018). https://doi.org/10.1038/s41372-018-0045-7

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