Maternal Glycemic Spectrum and Adverse Pregnancy and Perinatal Outcomes in a Multiracial US Cohort
Year: 2022
Type: article
Study design: Observational Study
Abstract: 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.
DOI: 10.3390/jcdd9060179
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,885
Funders: National Institute for Health and Care Research, National Institutes of Health, Health Resources and Services Administration, National Heart, Lung, and Blood Institute, National Institute of Environmental Health Sciences, Federal Office of Rural Health Policy, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: G1084853032, G2731613402, Pre-eclampsia and long-term cardio-metabolic outcomes, G3196599735, G3211154235, Maternal Exposure to Low Level Mercury, Metabolome, and Child Cardiometabolic Risk in Multi-Ethnic Prospective Birth Cohorts, Early Life Determinants of Obesity in U.S. Urban Low Income Minority Birth Cohort, G5172129032, Inter-generational Link of Cardio-Metabolic Risk: Integrate Multi-OMICs with Birth Cohort, G5575787713, G7140789098, Functional RNA Modifications, Micronutrient Exposure, Developmental Disabilities, Obesity Prevention in Postpartum Women at High-Risk of Cardiovascular Disease, G7486154929, G8186589718, Preterm Birth and Child Long-term Cardiometabolic Risk: Integrate Proteomics with Birth Cohort, Stress, inflammation and coronary endothelial injury in preeclampsia
OpenAlex ID: W4281932750