Impact of fasting blood glucose in early pregnancy and high-risk factors on gestational diabetes mellitus and other adverse perinatal outcomes in singleton and twin pregnancies
LI Xiang
SHENG Qing
WU Tian-chen
GONG Xiao-li
WANG Ying
CHEN Lian
YUAN Peng-bo
ZHAO Yang-yu
WEI Yuan
Abstract：Objective To explore the impact of fasting blood glucose(FPG)in early pregnancy and high-risk factors of gestational diabetes mellitus on development of gestational diabetes mellitus(GDM)and other adverse perinatal outcomes in singleton and twin pregnancies.Methods Retrospective analysis was performed on 17070 singleton and 1027 twin pregnancies who had regular prenatal examinations and delivered in Peking University Third Hospital from December 1,2011 to January 31,2021,concerning the general data,FPG results in early pregnancy and pregnancy outcomes of the pregnant women.Based on age,pre-pregnancy body mass index(BMI),GDM history,macrosomia delivery history,polycystic ovary syndrome,chronic hypertension and family history of diabetes,participants were grouped into GDM high-risk group and non-GDM high-risk group.T-test,x2test and binary logistic regression analysis were used for statistical analysis of the data.Results(1)In singleton pregnancy,early pregnancy FPG and GDM high-risk factors were related to GDM,and high-risk factors such as age,pre-pregnancy BMI,GDM history,macrosomia delivery history,polycystic ovary syndrome,chronic hypertension and family history of diabetes were all associated with GDM(P＜0.05).In twin pregnancies,early pregnancy FPG and GDM high-risk factors were associated with GDM,and age and pre-pregnancy BMI were the main high-risk factors(P＜0.05).Compared with twin pregnancies,pre-pregnancy BMI(P=0.023)and family history of diabetes(P=0.048)had a stronger association with GDM in singleton pregnancy.(2)In singleton pregnancy,with the increase of early pregnancy FPG,the risk of hypertensive disorders of pregnancy(HDP),macrosomia,and large for gestational age(LGA)increased,and the risk of small for gestational age(SGA)decreased(P＜0.05).In twin pregnancies,increased early pregnancy FPG was associated with an increased risk of one of the twin LGA and a decreased risk of cesarean section and one of the twin low-birth-weight infant(P＜0.05).Compared with twin pregnancies,early pregnancy FPG had a stronger association with HDP(P=0.036)and a weaker association with cesarean section(P=0.013)in singleton pregnancy.(3)In singleton pregnancy,the GDM high-risk group was associated with cesarean section,preterm birth,premature rupture of membranes,macrosomia,low-birth-weight infants,LGA,and SGA(P＜0.05).In twin pregnancies,the GDM high-risk factors were associated only with one of the twin being LGA(P=0.040).Compared with twin pregnancies,the GDM high-risk group had a stronger association with cesarean section,premature rupture of membranes and LGA in singleton pregnancies(P＜0.05).Conclusions In singleton and twin pregnancies,early pregnancy FPG and GDM high-risk factors are closely related to the incidence of GDM,and early pregnancy FPG is also related to other adverse perinatal outcomes.In singleton pregnancy,GDM risk factors were associated with cesarean section,preterm birth,premature rupture of membranes,macrosomia,low-birth-weight infants,LGA,and SGA,while in twin pregnancies,high-risk factors are associated only with one of the twin being LGA.
Keywords：twin pregnancygestational diabetes mellitusfasting blood glucose in early pregnancyhigh-risk factor
Publication Date：2025-03-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 228-233 )