Maternal pregestational blood sugar level tied to adverse pregnancy outcomes: BMJ

Adverse pregnancy outcomes included spontaneous abortion, induced abortion or labour due to medical reasons, stillbirth, preterm birth (PTB), macrosomia, large for gestational age, low birth weight (LBW) and small for gestational age.

The results of the study are as follows:

· Of the 60 360 pregnancies, rates of hypoglycaemic, normoglycaemia, impaired fasting glycaemia (IFG) and diabetic hyperglycaemic before conception were 5.06%, 89.30%, 4.59% and 1.05%, respectively.

· Compared with women with normoglycaemia, women with pregestational glucose at the diabetic level might have a higher rate of macrosomia, whereas pregestational IFG seemed to be associated with reduced risks of many adverse outcomes, including spontaneous abortion, induced abortion due to medical reasons, PTB and LBW.

· After adjusting for potential confounders, pregestational diabetic hyperglycaemic was remained to be significantly associated with an increased risk of macrosomia.

· Abnormal maternal glucose levels before pregnancy seemed to have no significant negative effect on spontaneous abortion or induced abortion due to medical reasons.

The researchers concluded that although without overt diabetes mellitus, women with once diabetic fasting glucose level during their preconception examinations could be associated with an increased risk for macrosomia. Uniform guidelines are needed for maternal blood glucose management during pre-pregnancy care to improve pregnancy outcomes.

Reference:

Association between maternal pregestational glucose level and adverse pregnancy outcomes: a population-based a retrospective cohort study by Zeng M et. al published in the Epidemiology.

http://dx.doi.org/10.1136/bmjopen-2020-048530