Bashir Mohammed, Khan Adeel, Ata Fateen, Abdel-Rahman Manar E, Eltaher Faten, Desoye Gernot, Konje Justin C, Abou-Samra Abdul-Badi
Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar.
National Diabetes Center, Women Wellness and Research Centre, Hamad Medical Corporation, Doha, Qatar.
Front Endocrinol (Lausanne). 2025 Jun 16;16:1595584. doi: 10.3389/fendo.2025.1595584. eCollection 2025.
In women with type 1 diabetes (T1D), the effects of glycaemic control on neonatal weight and the role of the placenta are not fully understood.
This study explores the relationship between glycaemic control, neonatal weight, and placental weight.
A retrospective observational longitudinal study of pregnant women with T1DM.
The study included 265 women with T1D. The target for the first A1c was set at ≤ 7.0%, while the target for the last A1c was ≤ 6.5%. The cohort was divided into four groups based on whether they achieved their target A1c (T) or had levels higher than the target (H) at each end. These groups were classified as Target-Target (T-T), Target-High (T-H), High-Target (H-T), and High-High (H-H). For the secondary objective, we included 154 women for whom placental weight data were available.
We assessed the association between firstA1c, lastA1c, and neonatal weight, examining the mediation effect of the placenta.
The mean age of the participants was 29.4 years (SD 4.6), and the mean T1DM duration was 14.1 years (SD 7.1). The median neonatal weight was highest in the T-H group (3.56 kg) and lowest in the H-T group (3.20 kg) (p=0.009). FirstA1c was negatively correlated with neonatal weight (β-coefficient -150.9, p < 0.01), whereas lastA1c positively correlated (β-coefficient 162.5, p < 0.01). The association with firstA1c disappeared when correcting for placental weight, while lastA1c remained significant. The placenta mediates 65% of the impact of firstA1c on neonatal weight.
Poor glycaemic control early in pregnancy is linked to lower neonatal birth weight, while poor control in the third trimester is associated with higher birth weight. These findings emphasize the importance of maintaining adequate glycaemic control before and during early pregnancy for better health outcomes.
在1型糖尿病（T1D）女性中，血糖控制对新生儿体重的影响以及胎盘的作用尚未完全明确。
本研究探讨血糖控制、新生儿体重和胎盘重量之间的关系。
一项对患有T1DM孕妇的回顾性观察性纵向研究。
该研究纳入了265名T1D女性。首次糖化血红蛋白（A1c）的目标设定为≤7.0%，而末次A1c的目标为≤6.5%。根据她们在两端是否达到目标A1c（T）或高于目标水平（H），将队列分为四组。这些组分别被分类为目标-目标（T-T）、目标-高（T-H）、高-目标（H-T）和高-高（H-H）。对于次要目标，我们纳入了154名有胎盘重量数据的女性。
我们评估了首次A1c、末次A1c与新生儿体重之间的关联，研究了胎盘的中介作用。
参与者的平均年龄为29.4岁（标准差4.6），平均T1DM病程为14.1年（标准差7.1）。新生儿体重中位数在T-H组最高（3.56千克），在H-T组最低（3.20千克）（p = 0.009）。首次A1c与新生儿体重呈负相关（β系数-150.9，p < 0.01），而末次A1c呈正相关（β系数162.5，p < 0.01）。校正胎盘重量后，与首次A1c的关联消失，而末次A1c仍然显著。胎盘介导了首次A1c对新生儿体重65%的影响。
妊娠早期血糖控制不佳与新生儿出生体重较低有关，而妊娠晚期控制不佳与出生体重较高有关。这些发现强调了在妊娠前和妊娠早期维持适当血糖控制以获得更好健康结局的重要性。
