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Early Diagnosed Gestational Diabetes Mellitus Is Associated With Adverse Pregnancy Outcomes: A Prospective Cohort Study
- Source :
- The Journal of Clinical Endocrinology & Metabolism. 105:e4264-e4274
- Publication Year :
- 2020
- Publisher :
- The Endocrine Society, 2020.
-
Abstract
- Context The significance of an early diagnosis of gestational diabetes mellitus (GDM) with oral glucose tolerance test (OGTT) has not been determined. Objective The objective of this work is to investigate GDM diagnosed by early and standard OGTTs and determine adverse maternal and neonatal outcomes associated with early GDM diagnosis. Research Design and Methods The Early Diagnosis of Gestational Diabetes Mellitus study is a prospective cohort study. Each participant in the study underwent 2 OGTTs, an early OGTT at 18 to 20 gestational weeks (gws) and a standard OGTT at 24 to 28 gws. The reproduciblity between early and standard OGTT were analyzed. Maternal and neonatal metabolic disorders and pregnancy outcomes were compared across groups. Results A total of 522 participants completed both the early and standard OGTTs. The glucose values in the early OGTT were not significantly different from those in the standard OGTT (fasting: 4.31 ± 0.41 mmol/L vs 4.29 ± 0.37 mmol/L, P = .360; 1-hour: 7.68 ± 1.71 mmol/L vs 7.66 ± 1.59 mmol/L, P = .826; 2-hour: 6.69 ± 1.47 mmol/L vs 6.71 ± 1.39 mmol/L, P = .800). The reproducibility of early and standard OGTT results was 74.9%. Pregnant women in the GDM group had higher glycated hemoglobin, C-peptide, and homeostasis model assessment of insulin resistance in the late gestational period. Neonates born to mothers in the GDM group were at a higher risk of being large for gestational age (odds ratio [OR]: 3.665; 95% CI, 1.006-11.91) and were also more prone to neonatal hyperinsulinemia (OR: 3.652; 95% CI, 1.152-10.533). Conclusion Early-onset GDM diagnosed by OGTT at 18 to 20 gws is associated with maternal and neonatal metabolic disorders and adverse pregnancy outcomes. Further randomized controlled trials on the therapeutic efficacy for early-onset GDM will confirm the significance of early screening for GDM.
- Subjects :
- Adult
China
medicine.medical_specialty
Adolescent
endocrine system diseases
Endocrinology, Diabetes and Metabolism
Clinical Biochemistry
Gestational Age
Context (language use)
Biochemistry
Cohort Studies
Young Adult
chemistry.chemical_compound
Endocrinology
Insulin resistance
Pregnancy
Prenatal Diagnosis
Internal medicine
Hyperinsulinemia
medicine
Humans
Prospective Studies
Age of Onset
Prospective cohort study
Obstetrics
business.industry
Biochemistry (medical)
Infant, Newborn
Pregnancy Outcome
nutritional and metabolic diseases
Gestational age
Odds ratio
Glucose Tolerance Test
Prognosis
medicine.disease
Pregnancy Complications
Gestational diabetes
Diabetes, Gestational
Early Diagnosis
chemistry
Female
Glycated hemoglobin
business
Subjects
Details
- ISSN :
- 19457197 and 0021972X
- Volume :
- 105
- Database :
- OpenAIRE
- Journal :
- The Journal of Clinical Endocrinology & Metabolism
- Accession number :
- edsair.doi.dedup.....5d56b841ef06ad7a1656b595260c474d