Does fasting plasma glucose values 5.1-5.6 mmol/l in the first trimester of gestation a matter?

Frontiers in Endocrinology

Endocrinology

Razieh Bidhendi-Yarandi¹  Fereidoun Azizi²  Farahnaz Torkestani³  Samira Behboudi-Gandevani⁴  Marzieh Bakhshandeh⁵  Mehrandokht Abedini⁶  Masoud Solaymani-Dodaran⁷  Farshad Farzadfar⁸  Majid Valizadeh⁹  Farhad Hosseinpanah⁹  Afshin Ostovar^1,10  Farzad Hadaegh^1,11  Davood Khalili^1,11  Maryam Rahmati^1,12  Fahimeh Ramezani Tehrani^1,12  Faegheh Firouzi^1,12  Marzieh Rostami Dovom^1,12  Mina Amiri^1,12 

[1] Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran;Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran;Faculty of Medicine, Shahed University, Tehran, Iran;Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway;Family Health Department, Ministry of Health and Medical Education, Tehran, Iran;Infertility and Cell Therapy Office, Transplant & Disease Treatment Center, Ministry of Health and Medical Education, Tehran, Iran;Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran;Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran;Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran;Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran;Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran;Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran;

关键词: early screening;    randomized non-inferiority field trial;    gestational diabetes;    first trimester of gestation;    glucose values 5.1-5.6 mmol/l;   

DOI  :  10.3389/fendo.2023.1155007

 received in 2023-01-31, accepted in 2023-04-13,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectivesThe aim of the study was to investigate the effect of treatment on pregnancy outcomes among women who had fasting plasma glucose (FPG) 5.1-5.6 mmol/l in the first trimester of pregnancy.MethodsWe performed a secondary-analysis of a randomized community non-inferiority trial of gestational diabetes mellitus (GDM) screening. All pregnant women with FPG values range 5.1-5.6 mmol/l in the first trimester of gestation were included in the present study (n=3297) and classified to either the (i) intervention group who received treatment for GDM along with usual prenatal care (n=1,198), (ii) control group who received usual-prenatal-care (n=2,099). Macrosomia/large for gestational age (LGA) and primary cesarean-section (C-S) were considered as primary-outcomes. A modified-Poisson-regression for binary outcome data with a log link function and robust error variance was used to RR (95%CI) for the associations between GDM status and incidence of pregnancy outcomes.ResultsThe mean maternal age and BMI of pregnant women in both study groups were similar. There were no statistically significant differences in the adjusted risks of adverse pregnancy outcomes, including macrosomia, primary C-S, preterm birth, hyperbilirubinemia, preeclampsia, NICU-admission, birth trauma, and LBW both groups.ConclusionsIt is found that treating women with first-trimester FPG values of 5.1-5.6 mmol/l could not improve adverse pregnancy outcomes including macrosomia, Primary C-S, Preterm birth, hypoglycemia, hypocalcemia, preeclampsia, NICU admission, Birth trauma and LBW. Therefore, extrapolating the FPG cut-off point of the second trimester to the first –which has been proposed by the IADPSG, might therefore not be appropriate.Clinical Trial Registrationhttps://www.irct.ir/trial/518, identifier IRCT138707081281N1.

【 授权许可】

Unknown   
Copyright © 2023 Ramezani Tehrani, Farzadfar, Hosseinpanah, Rahmati, Firouzi, Abedini, Hadaegh, Valizadeh, Torkestani, Khalili, Solaymani-Dodaran, Bidhendi-Yarandi, Bakhshandeh, Ostovar, Dovom, Amiri, Azizi and Behboudi-Gandevani