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Maternal fasting glycemia and adverse pregnancy outcomes in a Mediterranean population

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Abstract

Aims

The hyperglycemia and adverse pregnancy outcome study demonstrated a continuous association between fasting plasma glucose (FPG) levels below those diagnostic of diabetes and adverse neonatal outcomes. We aimed to investigate whether the same association was found in a Mediterranean population.

Methods

A retrospective analysis of singleton pregnancies attended at our Hospital between 2008 and 2015 (n = 5203). FPG was evaluated in the second trimester, and it was divided into 7 categories (1 < 75, 2 75–79, 3 80–84, 4 85–89, 5 90–94, 6 95–99 and 7 100–124 mg/dL). Pregnancy outcomes included elective cesarean delivery, gestational hypertensive disorders (GHD), large for gestational age (LGA), small for gestational age (SGA), macrosomia, prematurity, severe prematurity and APGAR at 1 min <7.

Results

Maternal age was 33.8 ± 3.8 years, and BMI at first antenatal visit was 22.9 ± 3.5 kg/m2; mean FPG was 79 ± 7 mg/dL. A positive association was observed between FPG and LGA (p < 0.001), GHD (p = 0.004) and prematurity both <37 and <34 weeks of gestation (p = 0.001 and p = 0.004). FPG and SGA were inversely related (p = 0,038). FPG was not significantly related to rate of C-section or APGAR. Adjusted odds ratios associated with 1 standard deviation increase in the fasting plasma glucose (7 mg/dL) were 1.26 (1.15 to 1.37) for LGA, 1.28 (1.09 to 1.49) for GHD and 0.83 (0.74–0.93) for SGA. In a multivariate analysis controlling for confounders, FPG remained associated with LGA.

Conclusions

We found an association between FPG levels, below those diagnostic of gestational diabetes according to our guidelines, and adverse maternal and neonatal outcomes in a Mediterranean population.

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Authors and Affiliations

  1. Endocrine Unit, Hospital Universitari Quirón-Dexeus, C/Sabino de Arana 5-19, 08028, Barcelona, Spain

    G. Sesmilo, V. Perea & M. Guerrero

  2. Obstetrical, Gynecologic and Reproductive Unit, Hospital Universitari Quirón-Dexeus, Barcelona, Spain

    E. Meler, I. Rodríguez, A. Rodríguez-Melcón & B. Serra

Authors
  1. G. Sesmilo
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  2. E. Meler
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  3. V. Perea
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  4. I. Rodríguez
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  5. A. Rodríguez-Melcón
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  6. M. Guerrero
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  7. B. Serra
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Corresponding author

Correspondence to G. Sesmilo.

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Conflict of interest

The authors have no relevant conflict of interest to disclose.

Ethical standard

The protocol was approved by the Hospital Ethical Committee.

Human and animal rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Declaration of Helsinki 1975, as revised in 2008 (5).

Informed consent

Informed consent was obtained from all patients for being included in the study.

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Managed by Massimo Federici.

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Sesmilo, G., Meler, E., Perea, V. et al. Maternal fasting glycemia and adverse pregnancy outcomes in a Mediterranean population. Acta Diabetol 54, 293–299 (2017). https://doi.org/10.1007/s00592-016-0952-z

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  • DOI: https://doi.org/10.1007/s00592-016-0952-z

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