Maternal Glycemic Spectrum and Adverse Pregnancy and Perinatal Outcomes in a Multiracial US Cohort

Journal of Cardiovascular Development and Disease

Guoying Wang¹  Xiumei Hong¹  Xiaobin Wang¹  Jennifer Lewey²  Pensee Wu³  Khurram Nasir⁴  Roger Scott Blumenthal⁴  Allison Gamboa Hays⁴  Yaa Adoma Kwapong⁴  Michael Joseph Blaha⁴  Garima Sharma⁴  Ellen Boakye⁴  Mamas Andreas Mamas⁵ 

[1] Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA;Division of Cardiology, Hospital of University of Pennsylvania, Philadelphia, PA 19104, USA;Division of Maternal and Fetal Medicine, Keele University, Keele ST5 5BG, UK;Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Diseases, Johns Hopkins School of Medicine, 600 N Wolfe St, Baltimore, MD 21287, USA;Keele Cardiovascular Research Group, School of Medicine, Keele University, Keele ST5 5BG, UK;

关键词: glycemia;    gestational diabetes;    adverse pregnancy outcomes;    cardiovascular risk;   

DOI  :  10.3390/jcdd9060179

来源: DOAJ

【 摘 要 】

Diabetes mellitus (pregestational (PDM) and gestational (GDM)) is associated with adverse pregnancy outcomes (APOs). However, studies exploring the association of APOs with maternal glycemia among women without PDM/GDM are limited. We utilized data from 4119 women (307—PDM; 582—GDM; 3230—non-PDM/GDM) in the Boston Birth Cohort (1998–2016). Women in the non-PDM/GDM group were subdivided by tertiles of 1 h, 50 g oral glucose load test at 24–32 weeks: T1: 50–95 mg/dL (n = 1166), T2: 96–116 mg/dL (n = 1151), T3: 117–201 mg/dL (n = 913). Using multivariable logistic regression, we examined the association of maternal glycemia with APOs—preterm birth (PTB) and hypertensive disorders of pregnancy (HDP)—and adverse perinatal outcomes—high birth weight (HBW), cesarean section (CS), and sub-analyses by race-ethnicity. Compared to women in T1, women in T2 and T3 had a higher prevalence of pre-existing hypertension (T1: 2.8% vs. T2: 5.2% vs. T3: 6.3%) and obesity (T1: 13.3% vs. T2: 18.1% vs. T3: 22.9%). Women in T2 and T3 had higher odds of HBW (adjusted odds ratio aOR T2: 1.47 [1.01–2.19] T3: 1.68 [1.13–2.50]) compared to women in T1. Additionally, women in T2, compared to T1, had higher odds of HDP (aOR 1.44 [1.10–1.88]). Among non-Hispanic Black (NHB) women, those in T2 and T3 had higher odds of HDP compared to T1 (aOR T2 1.67 [1.13–2.51]; T3: 1.68 [1.07–2.62]). GDM and PDM were associated with higher odds of HBW, CS, PTB, and HDP, compared to women in T1. In this predominantly NHB and Hispanic cohort, moderate maternal glycemia without PDM/GDM was associated with higher odds of HBW and HDP, even more strongly among NHB women. If confirmed, a review of current guidelines of glucose screening and risk stratification in pregnancy may be warranted.

【 授权许可】

Unknown