ECE2024 Oral Communications Oral Communications 4: Diabetes, Obesity, Metabolism and Nutrition | Part I (6 abstracts)
Glucose at gestational diabetes diagnosis predicts neonatal hypoglycaemia, large-for-gestational age and post-partum abnormal maternal glucose homeostasis
Catarina Cidade-Rodrigues 1 , Bruna Silva 1 , Catarina Chaves 1 , Vania Benido Silva 1 , Ana Saavedra 1 , Alexandra Araujo 1 , Claudia Machado 1 , Catarina Pereira 1 , Vania Gomes 1 , Odete Figueiredo 2 , Anabela Melo 2 , Anabela Ferreira 2 , Mariana Martinho 3 , Ana Morgado 2 , Margarida Almeida 1 , M Ceu Almeida 4 & Filipe Cunha 1
1Centro Hospitalar do Tâmega e Sousa, Endocrinology, Guilhufe, Portugal; 2Centro Hospitalar do Tâmega e Sousa, Gynecology and Obstetrics, Guilhufe, Portugal; 3Centro Hospitalar Vila Nova de Gaia / Espinho-Unit 1, Endocrinology, Vila Nova de Gaia, Portugal; 4Centro Hospitalar e Universitário de Coimbra, Gynecology and Obstetrics, Coimbra, Portugal
Introduction: Hyperglycaemia has been associated with worse maternal and foetal outcomes as well as higher risk for future type 2 diabetes (T2D).
Objectives: We study the association between glucose above diagnostic threshold (GADT) at gestational diabetes (GD) diagnosis and risk of perinatal complications and maternal glucose abnormalities at post-partum.
Materials and Methods: Retrospective study based on the national register of GD. Included women with live-born singleton pregnancies followed between 2012 and 2017. Excluded women without data on variables of interest. GADT defined as higher difference between measured glucose and diagnostic threshold at first trimester fasting glucose or 24-28th week OGTT. Primary endpoint: hypertensive disorders of pregnancy (HDP) – preeclampsia or gestational hypertension; preterm labour (PTL), caesarean section (CS), hypoglycaemia, large-for-gestational-age (LGA), and abnormal maternal glucose homeostasis (AMGH) at 4-12 weeks postpartum. Multivariate logistic regression models were built to test the association between GADT and the primary outcomes: adjustments for age, body mass index (BMI), family history of T2D, previous GD or macrosomia, insulin therapy, HbA1c, chronic hypertension, maternal excess weight gain during pregnancy, and time of GD diagnosis plus variables known to be associated with the primary outcome.
Results: We studied 6927 women with a median age of 34 (30-37) years and BMI of 25.8 (22.8-30.4) kg/m2. Median GADT was 5 (2-11) mg/dl. HDP was found in 336 (4.9%) of women, PTL in 406 (5.9%), CS in 2704 (39.0%), neonatal hypoglycaemia in 262 (3.8%), LGA in 728 (10.5%), and AMGH in 486 (7.0%) – T2D in 56 (0.8%). In the univariate analysis, GADT, per 5 mg/dl increase, was associated with HDP, CS, neonatal hypoglycaemia, LGA, and AMGH, but not PTL with an OR (95% CI) of 1.07 (1.00-1.14), P=0.04; 1.06 (1.03-1.09), P<0.001; 1.08 (1.01-1.16), P=0.03; 1.08 (1.03-1.13, P<0.001); 1.32 (1.27-1.38), P<0.001, and 1.03 (0.97-1.09), P=0.33. After multivariate adjustments, GADT, per 5 mg/dl, remained associated with neonatal hypoglycaemia [1.09 (1.01-1.18), P=0.03], LGA [1.06 (1.00-1.11), P=0.03], and AMGH [1.31 (1.25-1.38), P<0.001] but not with HDP [1.04 (0.97-1.11), P=0.30] and CS [1.00 (1.00-1.01), P=0.21].
Conclusions: GADT is associated with worse neonatal outcomes and with AMGH but not with obstetric outcomes. Per 5 mg/dl increase of GADT, there is a 9% higher risk of neonatal hypoglycaemia, 6% higher risk of LGA newborns and 31% higher risk of AGMH at postpartum reclassification.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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