Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore; Duke-NUS Medical School, Singapore; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A∗STAR), Singapore.
Duke-NUS Medical School, Singapore; Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore.
Fertil Steril. 2021 Jan;115(1):138-147. doi: 10.1016/j.fertnstert.2020.07.014. Epub 2020 Oct 15.
To examine the association between plasma glycemia in women attempting to conceive and fecundability, as measured by time to pregnancy.
Prospective preconception population-based study.
Hospital.
PATIENT(S): Asian preconception women, 18-45 years old, attempting conception for ≤12 cycles at study entry.
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): We ascertained time to pregnancy within a year of glycemic assessment in menstrual cycles. We estimated fecundability ratios (FRs) and 95% confidence intervals using discrete-time proportional hazards models, adjusting for age, ethnicity, education, body mass index, and cycle regularity and accounting for left truncation and right censoring.
RESULT(S): We studied a population sample of 766 women from the Singapore Preconception Study of Long-Term Maternal and Child Outcomes prospective cohort. Compared with women with normoglycemia, women with dysglycemia (prediabetes and diabetes, defined by the American Diabetes Association) had a lower FR (0.56). Compared with the respective lowest quintiles, women in the highest quintile of fasting glucose (≥5.1 mmol/L) had an FR of 0.60, while women in the highest 2-hour postload glucose quintile (≥6.9 mmol/L) had an FR of 0.66. Overall, the FRs decreased generally across the range of fasting and 2-hour plasma glucose. Glycated hemoglobin was not associated with fecundability.
CONCLUSION(S): Increasing preconception plasma glucose is associated with reduced fecundability, even within the normal range of glucose concentrations.
NCT03531658.
研究试图怀孕的女性血浆血糖与妊娠时间（即受孕能力）之间的关系。
前瞻性、基于人群的孕前研究。
医院。
亚洲备孕女性，年龄 18-45 岁，在研究入组时尝试怀孕≤12 个周期。
无。
我们在血糖评估后的 1 年内确定妊娠时间。我们使用离散时间比例风险模型估计受孕能力比值（FR）及其 95%置信区间，调整了年龄、种族、教育程度、体重指数以及周期规律性，并考虑了左截断和右删失。
我们研究了新加坡长期母婴结局孕前研究前瞻性队列中的 766 名女性的人群样本。与血糖正常的女性相比，血糖异常（美国糖尿病协会定义的糖尿病前期和糖尿病）的女性 FR 较低（0.56）。与各自的最低五分位数相比，空腹血糖最高五分位数（≥5.1mmol/L）的女性 FR 为 0.60，而 2 小时餐后血糖最高五分位数（≥6.9mmol/L）的女性 FR 为 0.66。总体而言，空腹和 2 小时血浆血糖的 FR 随着范围的增加而普遍降低。糖化血红蛋白与受孕能力无关。
孕前血浆葡萄糖升高与受孕能力降低有关，即使在葡萄糖浓度的正常范围内也是如此。
NCT03531658。
