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Elevated FPG May Increase Adverse Outcomes in GDM Pregnancies

Rates of LGA, hypertensive disorders of pregnancy up with fasting hyperglycemia in gestational diabetes

TUESDAY, Feb. 11, 2020 (HealthDay News) — Elevated fasting plasma glucose, compared with elevated postload glucose, in pregnancies in women with gestational diabetes is associated with a higher risk for adverse maternal and infant outcomes, according to a study published in the January issue of Diabetic Medicine.

Edmond A. Ryan, M.D., from the University of Alberta in Edmonton, Canada, and colleagues examined the associations of fasting plasma glucose versus postload glucose values with large-for-gestational-age (LGA) infants and hypertensive disorders of pregnancy among gestational diabetes pregnancies. Data were analyzed for 257,547 pregnant women, 5 percent of whom had gestational diabetes based on elevated fasting plasma glucose or elevated oral glucose tolerance test values.

The researchers found that the rates of LGA and hypertensive disorders of pregnancy were 8.1 and 5.1 percent in negative glucose challenge pregnancies, 11 and 7 percent in negative oral glucose tolerance test pregnancies, 22.4 and 11.9 percent in gestational diabetes pregnancies with elevated fasting plasma glucose, and 9.1 and 8 percent in gestational diabetes pregnancies with elevated postload glucose levels, respectively. Relative to pregnancies with postload glucose elevations only, those with elevated fasting plasma glucose had an increased risk for LGA and hypertensive disorders of pregnancy (adjusted odds ratios, 2.66 and 1.51, respectively). In gestational diabetes pregnancies with and without pharmacological intervention, fasting plasma glucose remained significantly associated with adverse outcomes.

“The persistence of adverse outcomes despite treatment highlights the need for future research to examine whether fasting hyperglycemia is a marker of some metabolic derangement that results in adverse outcomes in pregnancy,” the authors write.

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