Early diagnosed GDM tied to adverse pregnancy outcomes, metabolic disorders
Early-onset gestational diabetes mellitus (GDM) diagnosed by oral glucose tolerance test (OGTT) at 18–20 gestational weeks may lead to maternal and neonatal metabolic disorders and adverse pregnancy outcomes, a recent study has shown.
In this prospective cohort study, each participant underwent two OGTTs, an early OGTT at 18–20 gestational weeks, and a standard OGTT at 24–28 gestational weeks. The authors analysed the reproducibility between early and standard OGTT, as well as compared maternal and neonatal metabolic disorders and pregnancy outcomes across groups.
Overall, 522 women completed both the early and standard OGTTs. Glucose values were not significantly difference between early and standard OGTTs (fasting: 4.31±0.41 vs 4.29±0.37 mmol/L; p=0.360; 1-hour: 7.68±1.71 vs 7.66±1.59 mmol/L; p=0.826; 2-hour: 6.69±1.47 vs 6.71±1.39 mmol/L; p=0.800). The reproducibility of early and standard OGTT was 74.9 percent.
Pregnant women in the GDM group showed higher glycated haemoglobin, C-peptide, and homeostasis model assessment of insulin resistance in the late gestational period. Neonates born to mothers in the GDM group were also at increased risk of being large for gestational age (odds ratio [OR], 3.665, 95 percent CI, 1.006–11.91) and were more likely to develop neonatal hyperinsulinaemia (OR, 3.652, 95 percent CI, 1.152–10.533).
“Further randomized controlled trials on the therapeutic efficacy for early-onset GDM will confirm the significance of early screening for GDM,” the authors said.