Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark.
Department of Endocrinology and Metabolism, Rigshospitalet, Copenhagen, Denmark.
Diabetes Technol Ther. 2024 Aug;26(8):536-546. doi: 10.1089/dia.2023.0583. Epub 2024 Apr 22.
To compare glycemic metrics during pregnancy between women with type 1 diabetes (T1D) delivering large-for-gestational-age (LGA) and appropriate-for-gestational-age (AGA) infants, and to identify predictors of LGA infants. A cohort study including 111 women with T1D using intermittently scanned continuous glucose monitoring from conception until delivery. Average sensor-derived metrics: mean glucose, time in range in pregnancy (TIRp), time above range in pregnancy, time below range in pregnancy, and coefficient of variation throughout pregnancy and in pregnancy intervals of 0-10, 11-21, 22-33, and 34-37 weeks were compared between women delivering LGA and AGA infants. Predictors of LGA infants were sought for. Infant growth was followed until 3 months postdelivery. In total, 53% ( = 59) delivered LGA infants. Mean glucose decreased during pregnancy in both groups, with women delivering LGA infants having a 0.4 mmol/L higher mean glucose from 11-33 weeks ( = 0.01) compared with women delivering AGA infants. Mean TIRp >70% was obtained from 34 weeks in women delivering LGA infants and from 22-33 weeks in women delivering AGA infants. Independent predictors for delivering LGA infants were mean glucose throughout pregnancy and gestational weight gain. At 3 months postdelivery, infant weight was higher in infants born LGA compared with infants born AGA (6360 g ± 784 and 5988 ± 894, = 0.04). Women with T1D delivering LGA infants achieved glycemic targets later than women delivering AGA infants. Mean glucose and gestational weight gain were independent predictors for delivering LGA infants. Infants born LGA remained larger postdelivery compared with infants born AGA.
比较 1 型糖尿病(T1D)女性分娩巨大儿(LGA)和适当胎龄(AGA)婴儿的孕期血糖指标,并确定 LGA 婴儿的预测因素。一项队列研究纳入了 111 名使用间歇性扫描连续血糖监测的 T1D 女性,从受孕开始直至分娩。比较了两组女性在怀孕期间的平均传感器衍生指标:平均血糖、孕期血糖范围内时间(TIRp)、孕期血糖范围以上时间、孕期血糖范围以下时间以及整个孕期和孕期 0-10 周、11-21 周、22-33 周和 34-37 周的变异系数。研究了 LGA 婴儿的预测因素。随访婴儿的生长情况,直到分娩后 3 个月。共有 53%( = 59)的女性分娩了 LGA 婴儿。两组女性的孕期血糖均降低,与分娩 AGA 婴儿的女性相比,分娩 LGA 婴儿的女性从 11-33 周的平均血糖升高 0.4mmol/L( = 0.01)。分娩 LGA 婴儿的女性从 34 周开始,而分娩 AGA 婴儿的女性从 22-33 周开始,平均 TIRp>70%。分娩 LGA 婴儿的独立预测因素是整个孕期的平均血糖和妊娠体重增加。分娩后 3 个月,LGA 出生婴儿的体重高于 AGA 出生婴儿(6360 g ± 784 和 5988 g ± 894, = 0.04)。与分娩 AGA 婴儿的女性相比,患有 T1D 的女性分娩 LGA 婴儿的血糖目标较晚达到。平均血糖和妊娠体重增加是分娩 LGA 婴儿的独立预测因素。与 AGA 出生婴儿相比,LGA 出生婴儿出生后仍然较大。