Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Sep;32(9):1639-43.
doi: 10.2337/dc09-0688. Epub 2009 Jun 23.

First-trimester fasting hyperglycemia and adverse pregnancy outcomes

Shlomit Riskin-Mashiah  1 , Grace Younes, Amit Damti, Ron Auslender
Affiliations

First-trimester fasting hyperglycemia and adverse pregnancy outcomes

Shlomit Riskin-Mashiah et al. Diabetes Care. 2009 Sep.

Abstract

Objective: The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study found strong associations between higher levels of maternal glucose at 24-32 weeks, within what is currently considered normoglycemia and adverse pregnancy outcomes. Our aim was to evaluate the associations between first-trimester fasting plasma glucose level and adverse pregnancy outcomes.

Research design and methods: Charts of all patients who delivered at our hospital between June 2001 and June 2006 were reviewed. Only subjects with singleton pregnancy and a recorded first-trimester fasting glucose level were included. Women with pregestational diabetes, fasting glucose level >105 mg/dl, or delivery <24 weeks were excluded. Fasting glucose levels were analyzed in seven categories, similar to the HAPO study. The main outcomes were development of gestational diabetes mellitus (GDM), large-for-gestational-age (LGA) neonates and/or macrosomia, and primary cesarean section. Multivariate logistic regression analysis was used; significance was <0.05.

Results: A total of 6,129 women had a fasting glucose test at median of 9.5 weeks. There were strong, graded associations between fasting glucose level and primary outcomes. The frequency of GDM development increased from 1.0% in the lowest glucose category to 11.7% in the highest (adjusted odds ratio 11.92 [95% CI 5.39-26.37]). The frequency of LGA neonates and/or macrosomia increased from 7.9 to 19.4% (2.82 [1.67-4.76]). Primary cesarean section rate increased from 12.7 to 20.0% (1.94 [1.11-3.41]).

Conclusions: Higher first-trimester fasting glucose levels, within what is currently considered a nondiabetic range, increase the risk of adverse pregnancy outcomes. Early detection and treatment of women at high risk for these complications might improve pregnancy outcome.

PubMed Disclaimer

Figures

Figure 1
Figure 1
The relationship between maternal first-trimester fasting glucose level and frequency of primary outcomes. Fasting glucose categories are defined as follows: category 1, <75 mg/dl; category 2, 75–79 mg/dl; category 3, 80–84 mg/dl; category 4, 85–89 mg/dl; category 5, 90–94 mg/dl; category 6, 95–99 mg/dl; and category 7, 100–105 mg/dl.
See this image and copyright information in PMC

References

    1. Sermer M, Naylor CD, Farine D, Kenshole AB, Ritchie JW, Gare DJ, Cohen HR, McArthur K, Holzapfel S, Biringer A. The Toronto Tri-Hospital Gestational Diabetes Project: a preliminary review. Diabetes Care 1998; 21( Suppl. 2): B33– B42 - PubMed
    1. Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U, Coustan DR, Hadden DR, McCance DR, Hod M, McIntyre HD, Oats JJ, Persson B, Rogers MS, Sacks DA. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med 2008; 358: 1991– 2002 - PubMed
    1. Siegmund T, Rad NT, Ritterath C, Siebert G, Henrich W, Buhling KJ. Longitudinal changes in the continuous glucose profile measured by the CGMS in healthy pregnant women and determination of cut-off values. Eur J Obstet Gynecol Reprod Biol 2008; 139: 46– 52 - PubMed
    1. Genuth S, Alberti KG, Bennett P, Buse J, Defronzo R, Kahn R, Kitzmiller J, Knowler WC, Lebovitz H, Lernmark A, Nathan D, Palmer J, Rizza R, Saudek C, Shaw J, Steffes M, Stern M, Tuomilehto J, Zimmet P. Follow-up report on the diagnosis of diabetes mellitus. Diabetes Care 2003; 26: 3160– 3167 - PubMed
    1. National Diabetes Data Group. Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes 1979; 28: 1039– 1057 - PubMed