Early pregnancy hyperglycaemia as a significant predictor of large for gestational age neonates.
Early pregnancy hyperglycaemia as a significant predictor of large for gestational age neonates.
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DOI：
10.1007/s00592-021-01828-1
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发表时间：
2022-04
影响因子：
3.8
通讯作者：
Agampodi SB
中科院分区：
文献类型：
--
作者：
Jayasinghe IU;Koralegedara IS;Agampodi SB
我们的目的是确定早期妊娠高血糖对胎龄较大（LGA）新生儿的影响。 在妊娠早期的孕妇中进行了一项前瞻性队列研究。采用国际妊娠期糖尿病研究组（IADPSG）标准对妊娠期糖尿病（GDM）和妊娠期糖尿病（DM）进行一步血糖（PG）评估。研究的主要结局是大于胎龄儿（LGA）。共招募了2，709名参与者，平均年龄为28岁（SD = 5.4），中位胎龄（GA）为8周（四分位距[IQR] = 2）。妊娠早期（T1）GDM的患病率为15.0%（95%置信区间[CI] = 13.7-16.4）。在2.5%的参与者中检测到先前未诊断的DM。在2，285例中位分娩GA为38周（IQR = 3）的活产婴儿中，7.0%为LGA新生儿。在GDM和DM妇女中，LGA新生儿的累积发病率分别为11.1/100和15.5/100。DM和GDM妇女中LGA新生儿的相对风险分别为2.30（95%CI = 1.23-4.28）和1.80（95%CI = 1.27-2.53）。LGA新生儿发生高血糖的归因危险度为15.01%。T1空腹PG与新生儿出生体重和出生体重百分位数均显著相关。WHO建议的妊娠期高脂血症的标准是有效的，即使在T1，预测LGA新生儿。建议使用空腹PG的IADPSG阈值进行高危人群妊娠早期的风险评估。在线版本包含补充材料，可通过10.1007/s 00592 -021-01828-1获得。
We aimed to determine the effect of early pregnancy hyperglycaemia on having a large for gestational age (LGA) neonate. A prospective cohort study was conducted among pregnant women in their first trimester. One-step plasma glucose (PG) evaluation procedure was performed to assess gestational diabetes mellitus (GDM) and diabetes mellitus (DM) in pregnancy as defined by the World Health Organization (WHO) criteria with International Association of Diabetes in Pregnancy Study Group (IADPSG) thresholds. The main outcome studied was large for gestational age neonates (LGA). A total of 2,709 participants were recruited with a mean age of 28 years (SD = 5.4) and a median gestational age (GA) of eight weeks (interquartile range [IQR] = 2). The prevalence of GDM in first trimester (T1) was 15.0% (95% confidence interval [CI] = 13.7–16.4). Previously undiagnosed DM was detected among 2.5% of the participants. Out of 2,285 live births with a median delivery GA of 38 weeks (IQR = 3), 7.0% were LGA neonates. The cumulative incidence of LGA neonates in women with GDM and DM was 11.1 and 15.5 per 100 women, respectively. The relative risk of having an LGA neonate among women with DM and GDM was 2.30 (95% CI = 1.23–4.28) and 1.80 (95% CI = 1.27–2.53), respectively. The attributable risk percentage of a LGA neonate for hyperglycaemia was 15.01%. T1 fasting PG was significantly correlated with both neonatal birth weight and birth weight centile. The proposed WHO criteria for hyperglycaemia in pregnancy are valid, even in T1, for predicting LGA neonates. The use of IADPSG threshold for Fasting PG, for risk assessment in early pregnancy in high-risk populations is recommended. The online version contains supplementary material available at 10.1007/s00592-021-01828-1.
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作者：
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