Department of Endocrinology, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium.
Medicine, KU Leuven, Leuven, Belgium.
Front Endocrinol (Lausanne). 2023 Jun 2;14:1186339. doi: 10.3389/fendo.2023.1186339. eCollection 2023.
Data are limited on pregnancy outcomes of normal glucose tolerant (NGT) women with a low glycemic value measured during the 75g oral glucose tolerance test (OGTT). Our aim was to evaluate maternal characteristics and pregnancy outcomes of NGT women with low glycemia measured at fasting, 1-hour or 2-hour OGTT.
The Belgian Diabetes in Pregnancy-N study was a multicentric prospective cohort study with 1841 pregnant women receiving an OGTT to screen for gestational diabetes (GDM). We compared the characteristics and pregnancy outcomes in NGT women according to different groups [(<3.9mmol/L), (3.9-4.2mmol/L), (4.25-4.4mmol/L) and (>4.4mmol/L)] of lowest glycemia measured during the OGTT. Pregnancy outcomes were adjusted for confounding factors such as body mass index (BMI) and gestational weight gain.
Of all NGT women, 10.7% (172) had low glycemia (<3.9 mmol/L) during the OGTT. Women in the lowest glycemic group (<3.9mmol/L) during the OGTT had compared to women in highest glycemic group (>4.4mmol/L, 29.9%, n=482), a better metabolic profile with a lower BMI, less insulin resistance and better beta-cell function. However, women in the lowest glycemic group had more often inadequate gestational weight gain [51.1% (67) vs. 29.5% (123); p<0.001]. Compared to the highest glycemia group, women in the lowest group had more often a birth weight <2.5Kg [adjusted OR 3.41, 95% CI (1.17-9.92); p=0.025].
Women with a glycemic value <3.9 mmol/L during the OGTT have a higher risk for a neonate with birth weight < 2.5Kg, which remained significant after adjustment for BMI and gestational weight gain.
在口服葡萄糖耐量试验（OGTT）中测量到的低血糖值的正常糖耐量（NGT）女性的妊娠结局数据有限。我们的目的是评估在 OGTT 中空腹、1 小时或 2 小时时测量到低血糖的 NGT 女性的母体特征和妊娠结局。
比利时糖尿病妊娠研究是一项多中心前瞻性队列研究，纳入了 1841 名接受 OGTT 以筛查妊娠期糖尿病（GDM）的孕妇。我们比较了在 OGTT 中测量到的最低血糖值处于不同组别的 NGT 女性的特征和妊娠结局[（<3.9mmol/L）、（3.9-4.2mmol/L）、（4.25-4.4mmol/L）和（>4.4mmol/L）]。妊娠结局经过体重指数（BMI）和妊娠期体重增加等混杂因素的调整。
在所有 NGT 女性中，有 10.7%（172 人）在 OGTT 中出现低血糖（<3.9mmol/L）。与血糖最高组（>4.4mmol/L，29.9%，n=482）相比，OGTT 中血糖最低组（<3.9mmol/L）的女性具有更好的代谢特征，BMI 更低、胰岛素抵抗程度更低、β细胞功能更好。然而，血糖最低组的女性更常出现妊娠期体重增加不足[51.1%（67）与 29.5%（123）；p<0.001]。与血糖最高组相比，血糖最低组的女性更常分娩出体重<2.5kg 的新生儿[校正比值比 3.41，95%置信区间（1.17-9.92）；p=0.025]。
OGTT 中血糖值<3.9mmol/L 的女性新生儿体重<2.5kg 的风险更高，即使经过 BMI 和妊娠期体重增加的调整，这种关联仍然显著。
