Association between the early or late onset of gestational diabetes mellitus with neonatal adverse outcomes: a retrospective cohort study

Fabiana Vieira Duarte de Souza Reis^#^{1

2}, Carlos Izaias Sartorão Filho^#^{1

2}, Luis Sobrevia^#^{1

3}, Caroline Baldini Prudencio^#^{1

4}, Bruna Bologna^#¹, Luana Favaro Iamundo^#¹, Adriely Magyori^#¹, Luiz Takano^#¹, Raissa Escandiussi Avramidis^#¹, Rafael Guilen de Oliveira^#¹, Marilza Vieira Cunha Rudge^#¹, Angélica Mércia Pascon Barbosa^#^{5

6}; Diamater Study Group

Collaborators, Affiliations

Collaborators

Diamater Study Group:
I M P Calderon, F P Souza, T Lehana, C F O Graeff, C G Magalhães, R A A Costa, S A M Lima, M R K Rodrigues, S L Felisbino, W F Barbosa, F J Campos, G Bossolan, J E Corrente, H R C Nunes, J F Abbade, P S Rossignoli, C R Pedroni, Á N Atallah, Z I Jármy-Di Bella, S M M Uchôa, M A H Duarte, E A Mareco, M E Sakalem, N M Martinho, D G Bussaneli, M I G Orlandi, C Pascon, T D Dangió, C V C Rudge, F Piculo, G M Prata, C N F Carvalho, A B M Magyori, G T A Nava, T C D Caldeirão, R H L Shetty, D R A Reyes, F C B Alves, J P C Marcondes, M L S Takemoto, F A Pinheiro, S B C V Quiroz, T Pascon, S K Nunes, B B Catinelli, F V D S Reis, S M B Costa, M O Menezes, N J Santos, E M A Enriquez, A M Carr, G A Garcia, H C M Bassin, V P Barbosa, M Jacomin, A J B Silva, I O Lourenço, J Marostica de Sá, I P Caruso, L T Rasmussen, V K C Nogueira, J T Ribeiro-Paes, D C H França, H V M Bastos, M L A Heliodoro, M N Kuroda, H L Carvalho

Affiliations

¹ Postgraduate Program on Tocogynecology, Botucatu Medical School, São Paulo State University (Unesp), Botucatu, Brazil.
² Medical School, Educational Foundation of the Municipality of Assis, FEMA, Assis, Sao Paulo, Brazil.
³ NHMRC Centre for Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
⁴ Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, Brasil.
⁵ Postgraduate Program on Tocogynecology, Botucatu Medical School, São Paulo State University (Unesp), Botucatu, Brazil. angelicapascon@gmail.com.
⁶ Department of Physiotherapy and Occupational Therapy, Universidade Estadual Paulista (UNESP), Marília, Brazil. angelicapascon@gmail.com.

^# Contributed equally.

PMID: 39663535
PMCID: PMC11636010
DOI: 10.1186/s40842-024-00196-3

Association between the early or late onset of gestational diabetes mellitus with neonatal adverse outcomes: a retrospective cohort study

Fabiana Vieira Duarte de Souza Reis et al. Clin Diabetes Endocrinol. 2024.

. 2024 Dec 12;10(1):45.

doi: 10.1186/s40842-024-00196-3.

Authors

Collaborators

Diamater Study Group:
I M P Calderon, F P Souza, T Lehana, C F O Graeff, C G Magalhães, R A A Costa, S A M Lima, M R K Rodrigues, S L Felisbino, W F Barbosa, F J Campos, G Bossolan, J E Corrente, H R C Nunes, J F Abbade, P S Rossignoli, C R Pedroni, Á N Atallah, Z I Jármy-Di Bella, S M M Uchôa, M A H Duarte, E A Mareco, M E Sakalem, N M Martinho, D G Bussaneli, M I G Orlandi, C Pascon, T D Dangió, C V C Rudge, F Piculo, G M Prata, C N F Carvalho, A B M Magyori, G T A Nava, T C D Caldeirão, R H L Shetty, D R A Reyes, F C B Alves, J P C Marcondes, M L S Takemoto, F A Pinheiro, S B C V Quiroz, T Pascon, S K Nunes, B B Catinelli, F V D S Reis, S M B Costa, M O Menezes, N J Santos, E M A Enriquez, A M Carr, G A Garcia, H C M Bassin, V P Barbosa, M Jacomin, A J B Silva, I O Lourenço, J Marostica de Sá, I P Caruso, L T Rasmussen, V K C Nogueira, J T Ribeiro-Paes, D C H França, H V M Bastos, M L A Heliodoro, M N Kuroda, H L Carvalho

Affiliations

¹ Postgraduate Program on Tocogynecology, Botucatu Medical School, São Paulo State University (Unesp), Botucatu, Brazil.
² Medical School, Educational Foundation of the Municipality of Assis, FEMA, Assis, Sao Paulo, Brazil.
³ NHMRC Centre for Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
⁴ Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, Brasil.
⁵ Postgraduate Program on Tocogynecology, Botucatu Medical School, São Paulo State University (Unesp), Botucatu, Brazil. angelicapascon@gmail.com.
⁶ Department of Physiotherapy and Occupational Therapy, Universidade Estadual Paulista (UNESP), Marília, Brazil. angelicapascon@gmail.com.

^# Contributed equally.

PMID: 39663535
PMCID: PMC11636010
DOI: 10.1186/s40842-024-00196-3

Abstract

Background: The literature has been evolving to standardize gestational diabetes mellitus (GDM) diagnosis and terminology. The significance of timing in diagnosing hyperglycemia during pregnancy is underlined by evidence that women diagnosed at 24 weeks of gestation or earlier are at a higher risk of developing postpartum prediabetes, but its association with adverse outcomes for the newborn is controversial. We aimed to investigate the association between early-onset GDM and adverse outcomes in newborns and neonates, comparing it with the late-onset GDM model.

Methods: It was a retrospective cohort study conducted at the Perinatal Diabetes Research Center in Assis/SP, affiliated with the Botucatu Medical School-UNESP in Brazil. The group composition was as follows: early-onset participants had fasting glucose levels ≥ 92 mg/dL and < 126 mg/dL before 20 weeks of gestation, while late-onset participants had a negative first-trimester screening and a positive 75g-OGTT at 24-28 weeks. For early-onset GDM, a fasting glucose level of ≥ 92 mg/dL is a recognized threshold associated with an increased risk of adverse pregnancy outcomes, while < 126 mg/dL ensures the exclusion of overt diabetes. The criteria for late-onset GDM, involving a negative initial screening and a positive OGTT at 24-28 weeks, align with the standard diagnostic timeframe when insulin resistance typically peaks due to placental hormone secretion. The maternal baseline characteristics included pre-pregnancy body mass index (BMI; kg/m2) and pregnancy weight gain (kg), calculated as the difference between the final pregnancy weight (36 gestational weeks or more) and pre-pregnancy maternal weight, classified according to the pre-pregnancy BMI. Additionally, the perinatal outcomes evaluated in this study included gestational age (GA) at birth, birth weight (BW) categorized according to GA as adequate, large, or small and Apgar scores at the first and 5th minutes.

Results: Eight hundred eighty pregnant women were selected, of whom 203 (23.07%) presented GDM and were eligible from December 2016 to December 2021. Based on the timing onset of GDM, 89 (43.8%) were in the early-onset group, and 114 (56.2%) were in the late-onset group. The fasting plasma glucose values in the first trimester were higher in the early-onset group. The 75-g OGTT values were higher in the late-onset group. The final BMI was higher in the early-onset group. Univariate linear regression was performed to determine the relationship between late-onset and maternal and neonatal outcomes; however, no significant relation was detected.

Conclusion: Pregnant women with early-onset GDM showed a higher BMI during pregnancy, but there was no difference between early and late-onset GDM concerning neonatal adverse outcomes.

Keywords: Adverse pregnancy outcomes; Gestational diabetes mellitus; Glucose tolerance test; Neonatal outcome.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: Study was reviewed and approved by the Institutional Review Board -Botucatu (Letter of approval 1.048.565 issued on Apr 28, 2015) and by the Institutional Review Board (IRB-Assis number 1.716.895). Before enrollment, each woman was fully explained about the study and signed an informed consent form. Consent for publication: All authors assert that there are no undisclosed conflicts of interest (both personal and institutional) regarding specific financial interests that are relevant to the work conducted or reported in this manuscript. I have had full access to all the data in the study and thereby accept full responsibility for the integrity of the data and the accuracy of the data analysis. Competing interests: The authors declare no competing interests.

References

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Association between the early or late onset of gestational diabetes mellitus with neonatal adverse outcomes: a retrospective cohort study

Collaborators

Affiliations

Association between the early or late onset of gestational diabetes mellitus with neonatal adverse outcomes: a retrospective cohort study

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

References

LinkOut - more resources

Full Text Sources