Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Evanston, Illinois.
Department of Obstetrics of Obstetrics and Gynecology, University of Chicago Pritzker School of Medicine, Chicago, Illinois.
Am J Perinatol. 2021 Sep;38(11):1117-1121. doi: 10.1055/s-0041-1729878. Epub 2021 May 27.
The aim of this study was to evaluate whether a 1-hour glucose challenge test (GCT) ≥140 mg/dL in a nondiabetic index pregnancy is associated with the development of gestational diabetes mellitus (GDM) in a subsequent pregnancy.
We performed a retrospective cohort study from a single institution from June 2009 to December 2018. Women with a nondiabetic index singleton gestation who underwent a 1-hour GCT at 24 to 28 weeks and had a successive singleton delivery were included. GDM was defined by a 1-hour GCT of ≥ 200 mg/dL, ≥2 of 4 elevated values on a 3-hour GCT, or a diagnosis of GDM defined by International Classification of Disease codes in the electronic medical record. Univariable analyses were performed to evaluate the associations between an elevated 1-hour GCT result in the index pregnancy, maternal characteristics, and the development of GDM in the subsequent pregnancy. Variables found to be significant ( < 0.05) were included in multivariable analysis.
A total of 2,423 women were included. Of these, 340 (14.0%) had an elevated 1-hour GCT in the index pregnancy. Women with an elevated 1-hour GCT in the index pregnancy compared with those without were significantly more likely to be older, married, privately insured, of Hispanic ethnicity or Asian race, chronically hypertensive, have a higher body mass index (BMI), have a shorter inter-pregnancy interval, and to develop GDM in the subsequent pregnancy (14.4 vs. 3.3%, < 0.001). In multivariable analysis, an elevated 1-hour GCT (adjusted odds ratio [aOR]: 4.54, 95% confidence interval [CI]: 3.02-6.81), first-trimester BMI ≥30 kg/m in the index pregnancy (aOR: 3.10, 95% CI: 2.03-4.71), Asian race (aOR: 2.96, 95% CI: 1.70-5.12), Hispanic ethnicity (aOR: 2.11, 95% CI: 1.12-4.00), and increasing age (aOR: 1.07, 95% CI: 1.02-1.12) were significantly associated with an increased risk of GDM in the subsequent pregnancy.
An elevated 1-hour GCT in a nondiabetic index pregnancy is associated with a fourfold increased risk of GDM in a subsequent pregnancy.
· An abnormal 1 hour GCT in an index pregnancy is associated with GDM in a subsequent pregnancy.. · An abnormal 1 hour GCT may be an independent risk factor for GDM in a subsequent pregnancy.. · An abnormal 1 hour GCT is associated with a 4 fold increased risk of GDM in a subsequent pregnancy..
本研究旨在评估在非糖尿病指数妊娠中，1 小时葡萄糖挑战试验（GCT）≥140mg/dL 是否与随后妊娠中发生妊娠期糖尿病（GDM）有关。
我们进行了一项来自单机构的回顾性队列研究，时间为 2009 年 6 月至 2018 年 12 月。纳入在 24-28 周进行 1 小时 GCT 且随后有单胎分娩的非糖尿病指数单胎妊娠的女性。GDM 的定义为 1 小时 GCT ≥200mg/dL、3 小时 GCT 中有 2 次或以上 4 个值升高，或电子病历中采用国际疾病分类代码诊断的 GDM。采用单变量分析评估在指数妊娠中升高的 1 小时 GCT 结果、产妇特征与随后妊娠中 GDM 发生之间的相关性。有统计学意义（ < 0.05）的变量纳入多变量分析。
共纳入 2423 名女性。其中，340 名（14.0%）在指数妊娠中 1 小时 GCT 升高。与无升高的 1 小时 GCT 相比，在指数妊娠中 1 小时 GCT 升高的女性更可能年龄较大、已婚、私人保险、西班牙裔或亚洲人种、慢性高血压、体重指数（BMI）更高、孕次间隔较短，且更有可能在随后妊娠中发生 GDM（14.4% vs. 3.3%， < 0.001）。多变量分析显示，升高的 1 小时 GCT（调整后的优势比[aOR]：4.54，95%置信区间[CI]：3.02-6.81）、指数妊娠中第一孕期 BMI≥30kg/m（aOR：3.10，95% CI：2.03-4.71）、亚洲人种（aOR：2.96，95% CI：1.70-5.12）、西班牙裔（aOR：2.11，95% CI：1.12-4.00）和年龄增加（aOR：1.07，95% CI：1.02-1.12）与随后妊娠中 GDM 的风险增加显著相关。
非糖尿病指数妊娠中升高的 1 小时 GCT 与随后妊娠中 GDM 的风险增加四倍相关。
· 指数妊娠中异常的 1 小时 GCT 与随后妊娠中的 GDM 相关。· 异常的 1 小时 GCT 可能是随后妊娠中 GDM 的独立危险因素。· 异常的 1 小时 GCT 与随后妊娠中 GDM 的风险增加四倍相关。
