The impact of first trimester fasting glucose level on adverse perinatal outcome

J Perinatol. 2018 May;38(5):451-455. doi: 10.1038/s41372-018-0045-7. Epub 2018 Jan 29.

Abstract

Objective: To evaluate the impact of first trimester fasting glucose (FTFG) level on perinatal outcome.

Study design: A retrospective cohort study of singleton deliveries. Maternal and neonatal outcome were compared between two groups-women with FTFG < 95 mg/dl and FTFG ≥ 95 mg/dl. Women with pre-gestational diabetes were excluded.

Results: Five thousand and thirty women met inclusion criteria. Of whom, 4644 (92.3%) had FTFG < 95 mg/dl and 386 (7.7%) had FTFG ≥ 95 mg/dl. Women with FTFG ≥ 95 mg/dl had higher rates of gestational hypertension (2.33 vs. 0.7%) and gestational diabetes (9.07 vs. 2.86%), p < 0.05 for both. Moreover, they had higher rates of cesarean delivery and arrest of descent, p < 0.05. Composite diabetes outcome was significantly higher among women with FTFG ≥ 95 mg/dl (8 vs. 3%, p = 0.002). After adjusting for potential confounders, composite diabetes outcome (aOR = 1.942 95% CI 1.265-2.981, p = 0.002) and gestational hypertension (aOR = 2.827 95% CI 1.295-6.175, p = 0.009) remained significantly higher in the FTFG ≥ 95 mg/dl group.

Conclusion: FTFG ≥ 95 mg/dl is an independent risk factor for adverse perinatal outcome including gestational hypertension and diabetes-related complications.

MeSH terms

  • Adult
  • Blood Glucose / metabolism*
  • Cesarean Section / statistics & numerical data
  • Diabetes, Gestational / epidemiology*
  • Female
  • Glucose Tolerance Test
  • Humans
  • Hypertension, Pregnancy-Induced / epidemiology*
  • Infant, Newborn
  • Israel / epidemiology
  • Logistic Models
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy Trimester, First / blood*
  • Retrospective Studies
  • Risk Factors

Substances

  • Blood Glucose