CoChat
Sign Up
Cited by 37Gestational Diabetes Research and ManagementPregnancy and preeclampsia studiesPregnancy and Medication Impact

Adverse obstetric outcomes in early‐diagnosed gestational diabetes mellitus: The Japan Environment and Children’s Study

Open access
Kyozuka, Hyo, Yasuda, Shun, Murata, Tsuyoshi, Fukuda, Toma, Yamaguchi, Akiko, Kanno, Aya, Sato, Akiko, Ogata, Yuka +6 more·2021·Journal of Diabetes Investigation
DOI 10.1111/jdi.13569PMC PMC8565414
Open this paper in CoChat — free accountOpen PDF

Abstract

Aims/Introduction: To examine adverse outcomes in women with early‐diagnosed gestational diabetes mellitus using data from a large birth cohort study in Japan. Materials and Methods: This study analyzed data from singleton pregnancies in the Japan Environment and Children’s Study including births during 2011–2014. Mothers with an HbA1c level ≥6.5% in the first trimester, a history of diabetes mellitus, or steroid use during pregnancy were excluded. The participants were divided into three groups: control (without gestational diabetes mellitus), early‐diagnosed gestational diabetes mellitus (diagnosed before gestational week 24), and late‐diagnosed gestational diabetes mellitus (diagnosed after gestational week 24). Multiple logistic regression analysis was performed to calculate the risk of early‐diagnosed and late‐diagnosed gestational diabetes mellitus for adverse obstetrics outcomes. Results: In total, 100,376 eligible participants were included in this study. The number of individuals in control cases, early‐diagnosed gestational diabetes mellitus cases, and late‐diagnosed gestational diabetes mellitus cases was 98,090 (97.7%), 751 (0.7%), and 1,535 (1.5%), respectively. When control cases were used as reference, multiple logistic regression analysis revealed that early‐diagnosed gestational diabetes mellitus increased the risk of hypertensive disorders of pregnancy (adjusted odds ratio: 2.08, 95% confidence interval: 1.51–2.86), early‐onset hypertensive disorders of pregnancy (adjusted odds ratio: 1.91, 95% confidence interval: 1.01–3.65), and late‐onset hypertensive disorders of pregnancy (adjusted odds ratio: 1.92, 95% confidence interval: 1.29–2.86). Conclusion: Early‐diagnosed gestational diabetes mellitus is associated with serious obstetric complications. Our findings indicate the necessity of further investigations to validate the benefit of early screening for gestational diabetes mellitus in pregnant women.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1111/jdi.13569

Cites

4 of 4 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Women diagnosed with GDM during the first half of pregnancy have a higher incidence of pre-eclampsia and cesarean section.

    “Incidentally, one study on the prognosis of GDM in the first half of pregnancy in Japan reported that women diagnosed with GDM during the first half of pregnancy had a higher incidence of pre‐eclampsia and cesarean section 10 .”

    From Clinical challenges in early pregnancy in Japan: An update on gestational diabetes (2024) · cites this paper as [10]

    The Results (Table 3; page unavailable) report a higher cesarean-delivery rate in the early-diagnosed GDM group. They also report more hypertensive disorders of pregnancy, but the Methods define that broader outcome as new-onset hypertension; the paper does not report pre-eclampsia incidence separately. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 29

  1. [1]Metzger BE, Coustan DR. Summary and recommendations of the Fourth International Workshop‐Conference on Gestational Diabetes Mellitus. The Organizing Committee. Diabetes Care 1998; 21(Suppl 2): B161‐ B167. 9704245
  2. [2]Koivusalo SB, Rönö K, Klemetti MM, et al. Gestational diabetes mellitus can be prevented by lifestyle intervention: the Finnish gestational diabetes prevention study (RADIEL): a randomized controlled trial. Diabetes Care 2016; 39: 24– 30. 26223239
  3. [3]Reece EA, Homko CJ. Infant of the diabetic mother. Semin Perinatol 1994; 18: 459– 469. 7824972
  4. [4]Silverman BL, Rizzo TA, Cho NH, et al. Long‐term effects of the intrauterine environment. The Northwestern University Diabetes in Pregnancy Center. Diabetes Care 1998; 21(Suppl 2): B142– B149. 9704242
  5. [5]Adane AA, Mishra GD, Tooth LR. Diabetes in pregnancy and childhood cognitive development: a systematic review. Pediatrics 2016; 137: e20154234. 27244820
  6. [7]American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2012; 35(Suppl 1): S64– S71. 22187472 PMC3632174
  7. [11]Minakami H, Maeda T, Fujii T, et al. Guidelines for obstetrical practice in Japan: Japan Society of Obstetrics and Gynecology (JSOG) and Japan Association of Obstetricians and Gynecologists (JAOG). J Obstet Gynaecol Res 2014; 40: 1469– 1499. 24888907
  8. [12]Liu B, Cai J, Xu Y, et al. Early diagnosed gestational diabetes mellitus is associated with adverse pregnancy outcomes: a prospective cohort study. J Clin Endocrinol Metab 2020; 105: dgaa633. 32898218
  9. [13]Usami T, Yokoyama M, Ueno M, et al. Comparison of pregnancy outcomes between women with early‐onset and late‐onset gestational diabetes in a retrospective multi‐institutional study in Japan. J Diabetes Investig 2020; 11: 216– 222. PMC6944816 31199576
  10. [14]Kawamoto T, Nitta H, Murata K, et al. Rationale and study design of the Japan environment and children’s study (JECS). BMC Public Health 2014; 14: 25. 24410977 PMC3893509
  11. [15]Nakanishi S, Aoki S, Kasai J, et al. High probability of false‐positive gestational diabetes mellitus diagnosis during early pregnancy. BMJ Open Diabetes Res Care 2020; 8: e001234. PMC7375392 32699112
  12. [16]Myoga M, Tsuji M, Tanaka R, et al. Impact of sleep duration during pregnancy on the risk of gestational diabetes in the Japan environmental and Children's study (JECS). BMC Pregnancy Childbirth 2019; 19: 483. 31818260 PMC6902452
  13. [17]Kyozuka H, Yamaguchi A, Suzuki D, et al. Risk factors for placenta accreta spectrum: findings from the Japan environment and Children's study. BMC Pregnancy Childbirth 2019; 19: 447. 31775687 PMC6882023
  14. [18]Kyozuka H, Fujimori K, Hosoya M, et al. The Japan Environment and Children's Study (JECS) in Fukushima prefecture: pregnancy outcome after the Great East Japan Earthquake. Tohoku J Exp Med 2018; 246: 27– 33. 30210086
  15. [19]Yamaguchi A, Kyozuka H, Fujimori K, et al. Risk of preterm birth, low birthweight and small‐for‐gestational‐age infants in pregnancies with adenomyosis: a cohort study of the Japan Environment and Children's Study. Acta Obstet Gynecol Scand 2019; 98: 359– 364. 30367455
  16. [20]Furukawa TA, Kawakami N, Saitoh M, et al. The performance of the Japanese version of the K6 and K10 in the World Mental Health Survey Japan. Int J Methods Psychiatr Res 2008; 17: 152– 158. 18763695 PMC6878390
  17. [21]Itabashi K, Miura F, Uehara R, et al. New Japanese neonatal anthropometric charts for gestational age at birth. Pediatr Int 2014; 56: 702– 708. 24617834
  18. [22]Kyozuka H, Fujimori K, Hosoya M, et al. The effect of maternal age at the first childbirth on gestational age and birth weight: the Japan Environment and Children's Study (JECS). J Epidemiol 2019; 29: 187– 191. 30078812 PMC6445800
  19. [23]Kyozuka H, Murata T, Fukuda T, et al. Association between pre‐pregnancy calcium intake and hypertensive disorders during the first pregnancy: the Japan Environment and Children's Study. BMC Pregnancy Childbirth 2020; 20: 424. 32723367 PMC7385887
  20. [24]Kyozuka H, Fukusda T, Murata T, et al. Impact of preconception sodium intake on hypertensive disorders of pregnancy: the Japan Environment and Children’s Study. Pregnancy Hypertens 2021; 23: 66– 72. 33264705
  21. [25]Victory R, Penava D, Da Silva O, et al. Umbilical cord pH and base excess values in relation to adverse outcome events for infants delivering at term. Am J Obstet Gynecol 2004; 191: 2021– 2028. 15592286
  22. [26]Yeh P, Emary K, Impey L. The relationship between umbilical cord arterial pH and serious adverse neonatal outcome: analysis of 51,519 consecutive validated samples. BJOG 2012; 119: 824– 831. 22571747
  23. [27]MacLennan A. A template for defining a causal relation between acute intrapartum events and cerebral palsy: international consensus statement. BMJ 1999; 319: 1054– 1059. 10521205 PMC1116849
  24. [28]Kyozuka H, Fukuda T, Murata T, et al. Comprehensive metabolomic analysis of first‐trimester serum identifies biomarkers of early‐onset hypertensive disorder of pregnancy. Sci Rep 2020; 10: 13857. 32807817 PMC7431422
  25. [29]Goyal A, Gupta Y, Singla R, et al. American Diabetes Association "Standards of Medical Care‐2020 for Gestational Diabetes Mellitus": a critical appraisal. Diabetes Ther 2020; 11: 1639– 1644. 32564336 PMC7376815
  26. [30]Weinert LS. International Association of Diabetes and Pregnancy Study Groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy: comment to the International Association of Diabetes and Pregnancy Study Groups Consensus Panel. Diabetes Care 2010; 33: e97– e98. 20190296 PMC2827530
  27. [31]Sugiyama T, Saito M, Nishigori H, et al. Comparison of pregnancy outcomes between women with gestational diabetes and overt diabetes first diagnosed in pregnancy: a retrospective multi‐institutional study in Japan. Diabetes Res Clin Pract 2014; 103: 20– 25. 24405981
  28. [32]Vandorsten JP, Dodson WC, Espeland MA, et al. NIH consensus development conference: diagnosing gestational diabetes mellitus. NIH Consens State Sci Statements 2013; 29: 1– 31. 23748438
  29. [33]American Diabetes Association. 14. Management of diabetes in pregnancy: Standards of Medical Care in Diabetes‐2020. Diabetes Care 2020; 43: S183‐ S192. 31862757

Cited by

Sorted by citations

Authors
Kyozuka, H., Yasuda, S., Murata, T., Fukuda, T., Yamaguchi, A., Kanno, A., Sato, A., Ogata, Y., Hosoya, M., Yasumura, S., Hashimoto, K., Nishigori, H., Fujimori, K., & The Japan Environment and Children’s Study (JECS) Group
Affiliations
  • Fukushima Medical University (JP)
  • Fukushima Regional Center for the Japan Environmental and Children’s Study Fukushima Japan
Corresponding author
Kyozuka, Hyo
ORCID
Venue
Journal of Diabetes Investigation
Publisher
Wiley
Published
2021-06-09
Volume
12
Issue
11
Pages
2071-2079
ISSN
  • 2040-1116 (ISSN-L)
  • 2040-1124
DOI
10.1111/jdi.13569
PMC
PMC8565414
OpenAlex
W3158983910
Cited by
37
References
4
Citations by year
2026: 7 · 2025: 9 · 2024: 3 · 2023: 7 · 2022: 7 · 2021: 4
FWCI
5.22
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Diabetes Investigation (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • National Center for Child Health and Development
  • Nagoya City University
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
Keywords
gestational diabetes mellitus, early diagnosis, delayed diagnosis, hypertensive disorders of pregnancy, preeclampsia, pregnancy complications, gestational diabetes screening, Japan Environment and Children's Study, singleton pregnancy
MeSH terms
Adult, Female, Glycated Hemoglobin, Humans, Japan, Pregnancy, Pregnancy Outcome, Pregnancy Trimester, First, Pregnancy Trimester, Second, Prenatal Diagnosis, Time Factors, Logistic Models, Odds Ratio, Case-Control Studies, Diabetes, Gestational, Early Diagnosis, Hypertension, Pregnancy-Induced, Delayed Diagnosis

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review