First-trimester fasting glycemia as a predictor of gestational diabetes (GDM) and adverse pregnancy outcomes
Abstract
Aims Studies to prevent gestational diabetes (GDM) have shown the best results when lifestyle measures have been applied early in pregnancy. We aimed to investigate whether first-trimester fasting plasma glucose (FPG) could predict GDM risk and adverse pregnancy outcomes. Methods A retrospective analysis of prospectively collected data from singleton pregnancies who were attended at our hospital between 2008 and 2018 (n = 27,198) was performed. We included patients with a recorded first-trimester FPG and complete pregnancy data (n = 6845). Patients under 18, with pregestational diabetes or reproductive techniques, were excluded. First-trimester FPG was evaluated as a continuous variable and divided into quartiles. GDM was diagnosed by NDDG criteria. The relationship between first- and second-trimester glucose > 92 mg/dL was also investigated. The relationship between FPG and pregnancy outcomes was assessed in 6150 patients who did not have GDM. Results Maternal age was 34.2 ± 3.9 years, BMI 23.1 ± 3.7 kg/m 2 and mean FPG 83.0 ± 7.3 mg/dL. Glucose quartiles were: ≤ 78, 79-83, 84-87 and ≥ 88 mg/dL. First-trimester FPG predicted the risk of GDM (7%, 8%, 10.2% and 16% in each quartile, p < 0.001) and the risk of second-trimester glucose > 92 mg/dL (2.6%, 3.8%, 6.3% and 11.4% in each quartile, p < 0.001). FPG was significantly associated with LGA (8.2%, 9.3%, 10% and 11.7% in each quartile, p = 0.011) but not with other obstetrical outcomes. In a multivariate analysis including age, BMI, tobacco use, number of pregnancies and weight gained during pregnancy, first-trimester FPG was an independent predictor of LGA. Conclusions First-trimester FPG is an early marker of GDM and LGA.
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Many scientific papers emphasize the validity of screening for gestational diabetes mellitus in the first trimester of pregnancy.
“Currently, there are many scientific papers emphasizing the validity of screening for GDM in the first trimester of pregnancy [6,7,8,9].”
From Evolution of Gestational Diabetes Mellitus across Continents in 21st Century (2022) · cites this paper as [9]
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Evolution of Gestational Diabetes Mellitus across Continents in 21st Century
Dłuski, D. F., Ruszała, M., Rudziński, G., Pożarowska, K., Brzuszkiewicz, K., & Leszczyńska-Gorzelak, B. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192315804 · Cited by 41 · see citing works
- Authors
- Sesmilo, G., Prats, P., Garcia, S., Rodríguez, I., Rodríguez-Melcón, A., Berges, I., & Serra, B.
- Affiliations
- Hospital Universitario Dexeus (ES)
- Corresponding author
- Sesmilo, G.
- Venue
- Acta Diabetologica
- Published
- 2020-01-27
- Volume
- 57
- Issue
- 6
- Pages
- 697-703
- ISSN
- 0940-5429 (ISSN-L)
- 1432-5233
- OpenAlex
- W3004118829
- Cited by
- 60
- References
- 12
- Citations by year
- 2026: 2 · 2025: 9 · 2024: 10 · 2023: 10 · 2022: 8 · 2021: 17 · 2020: 4
- FWCI
- 5.93
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Acta Diabetologica (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- gestational diabetes mellitus, GDM risk prediction, large for gestational age, adverse pregnancy outcomes, early pregnancy biomarkers, singleton pregnancy
- MeSH terms
- Adult, Blood Glucose, Fasting, Female, Fetal Macrosomia, Glucose Tolerance Test, Humans, Infant, Newborn, Longitudinal Studies, Male, Pregnancy, Pregnancy Outcome, Pregnancy Trimester, First, Prenatal Diagnosis, Prognosis, Retrospective Studies, Prevalence, Diabetes, Gestational
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