Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2023 Sep 4;38(35):e286. doi: 10.3346/jkms.2023.38.e286.
We sought to identify the influence of prepregnancy glucose levels on obstetric complications in subsequent pregnancy.
Women in Republic of Korea who had given birth between January 1st, 2007 and December 31st, 2010 were enrolled. The database of the Health Insurance Review and Assessment Service and data from a national health screening program for infants and children were used. Subjects were divided into seven groups according to their fasting glucose levels.
59,619 women were included for analysis, and 10.4%, 13.7%, 19.1%, 21.5%, 16.0%, 11.6%, and 7.5% women had glucose levels of < 75, 75-79, 80-84, 85-89, 90-94, 95-100 and > 100 mg/dL. Each 5 mg/dL increase in prepregnancy fasting glucose levels was associated with increased risk of gestational diabetes and macrosomia in subsequent pregnancy. Adjusted risk ratio for gestational diabetes per standard deviation prepregnancy glucose > 100 mg/dL was 2.015 (95% confidence interval, 1.649-2.462) and for macrosomia an adjusted risk ratio 1.389 (95% confidence interval, 1.147-1.682).
Higher prepregnancy glucose level within normal range was related to gestational diabetes and macrosomia in following pregnancy. Our results may aid in the identification of women at future risk of obstetric complications and may guide to stratify women into normal and intensified care.
Higher prepregnancy glucose in normal range is associated with gestational diabetes and macrosomia.
本研究旨在探讨孕前血糖水平对再次妊娠时产科并发症的影响。
本研究纳入 2007 年 1 月 1 日至 2010 年 12 月 31 日期间在韩国分娩的女性。研究使用了健康保险审查和评估服务数据库和全国婴幼儿健康筛查计划的数据。根据空腹血糖水平,将受试者分为 7 组。
共纳入 59619 名女性进行分析,血糖水平<75、75-79、80-84、85-89、90-94、95-100 和>100mg/dL 的女性分别占 10.4%、13.7%、19.1%、21.5%、16.0%、11.6%和 7.5%。与孕前空腹血糖水平每增加 5mg/dL 相关,再次妊娠时妊娠期糖尿病和巨大儿的风险增加。与孕前血糖水平<75mg/dL 相比,孕前血糖水平>100mg/dL 时妊娠期糖尿病的校正风险比为 2.015(95%置信区间,1.649-2.462),巨大儿的校正风险比为 1.389(95%置信区间,1.147-1.682)。
正常范围内较高的孕前血糖水平与再次妊娠时的妊娠期糖尿病和巨大儿有关。我们的研究结果可能有助于识别未来存在产科并发症风险的女性,并指导将女性分为普通和强化管理。
正常范围内较高的孕前血糖与妊娠期糖尿病和巨大儿有关。