Effects of gestational diabetes mellitus and mid-pregnancy blood glucose levels on gestational weeks based on birth cohort study / 西安交通大学学报(医学版)

ABSTRACT

【Objective】 To explore the effects of gestational diabetes mellitus (GDM) and mid-pregnancy blood glucose levels on gestational weeks in Northwestern China. 【Methods】 For this prospective cohort study, we recruited the first-trimester pregnant women who underwent obstetrical examinations at Northwest Women’s and Children’s Hospital from July 2018 to July 2019 as the cohort. We investigated their socio-demographic characteristics and risk factors of adverse pregnancy outcomes. Additionally, we collected the OGTT test results of pregnant women in mid-pregnancy and followed up their pregnancy outcomes. The relationship of GDM and blood glucose levels with gestational weeks was analyzed by using the generalized linear model. 【Results】 A total of 2 434 subjects were included in this study. There were 668 pregnant women with GDM, with a ratio of 27.44%. GDM in pregnant women shortened the gestational weeks (β=-0.17, 95% CI -0.28—-0.05). Fasting blood glucose, OGTT-1 h blood glucose, and OGTT-2 h blood glucose increased by 1 mmol/L; gestational weeks were shortened by 0.17 (95% CI -0.28—-0.05), 0.05 (95% CI -0.09—-0.02) and 0.07 (95% CI -0.12—-0.03). Fasting blood glucose and OGTT-1 h blood glucose abnormalities shortened gestational weeks by 0.18 (95% CI -0.31—-0.05) and 0.28 (95% CI -0.47—-0.10) respectively. An increase by 1 mmol/L or abnormality of fasting blood glucose would increase preterm delivery risk by 1.44 (95% CI 1.01-2.06) and 1.73 times (95% CI 1.10-2.69), respectively. 【Conclusion】 GDM in pregnant women may shorten their gestational weeks; the abnormal and elevated fasting blood glucose, in particular, would increase the risk of preterm delivery. Therefore, we should carry out active health education to control the blood glucose and other risk factors of GDM patients and promote healthy pregnancy.