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Maternal Glycemic Spectrum and Adverse Pregnancy and Perinatal Outcomes in a Multiracial US Cohort

Diabetes mellitus (pregestational (PDM) and gestational (GDM)) is associated with adverse pregnancy outcomes (APOs). However, studies exploring the association of APOs with maternal glycemia among women without PDM/GDM are limited. We utilized data from 4119 women (307—PDM; 582—GDM; 3230—non-PDM/GDM...

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Autores principales: Kwapong, Yaa Adoma, Boakye, Ellen, Wang, Guoying, Hong, Xiumei, Lewey, Jennifer, Mamas, Mamas Andreas, Wu, Pensee, Blaha, Michael Joseph, Nasir, Khurram, Hays, Allison Gamboa, Blumenthal, Roger Scott, Wang, Xiaobin, Sharma, Garima
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9224544/
https://www.ncbi.nlm.nih.gov/pubmed/35735808
http://dx.doi.org/10.3390/jcdd9060179
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author Kwapong, Yaa Adoma
Boakye, Ellen
Wang, Guoying
Hong, Xiumei
Lewey, Jennifer
Mamas, Mamas Andreas
Wu, Pensee
Blaha, Michael Joseph
Nasir, Khurram
Hays, Allison Gamboa
Blumenthal, Roger Scott
Wang, Xiaobin
Sharma, Garima
author_facet Kwapong, Yaa Adoma
Boakye, Ellen
Wang, Guoying
Hong, Xiumei
Lewey, Jennifer
Mamas, Mamas Andreas
Wu, Pensee
Blaha, Michael Joseph
Nasir, Khurram
Hays, Allison Gamboa
Blumenthal, Roger Scott
Wang, Xiaobin
Sharma, Garima
author_sort Kwapong, Yaa Adoma
collection PubMed
description Diabetes mellitus (pregestational (PDM) and gestational (GDM)) is associated with adverse pregnancy outcomes (APOs). However, studies exploring the association of APOs with maternal glycemia among women without PDM/GDM are limited. We utilized data from 4119 women (307—PDM; 582—GDM; 3230—non-PDM/GDM) in the Boston Birth Cohort (1998–2016). Women in the non-PDM/GDM group were subdivided by tertiles of 1 h, 50 g oral glucose load test at 24–32 weeks: T1: 50–95 mg/dL (n = 1166), T2: 96–116 mg/dL (n = 1151), T3: 117–201 mg/dL (n = 913). Using multivariable logistic regression, we examined the association of maternal glycemia with APOs—preterm birth (PTB) and hypertensive disorders of pregnancy (HDP)—and adverse perinatal outcomes—high birth weight (HBW), cesarean section (CS), and sub-analyses by race-ethnicity. Compared to women in T1, women in T2 and T3 had a higher prevalence of pre-existing hypertension (T1: 2.8% vs. T2: 5.2% vs. T3: 6.3%) and obesity (T1: 13.3% vs. T2: 18.1% vs. T3: 22.9%). Women in T2 and T3 had higher odds of HBW (adjusted odds ratio aOR T2: 1.47 [1.01–2.19] T3: 1.68 [1.13–2.50]) compared to women in T1. Additionally, women in T2, compared to T1, had higher odds of HDP (aOR 1.44 [1.10–1.88]). Among non-Hispanic Black (NHB) women, those in T2 and T3 had higher odds of HDP compared to T1 (aOR T2 1.67 [1.13–2.51]; T3: 1.68 [1.07–2.62]). GDM and PDM were associated with higher odds of HBW, CS, PTB, and HDP, compared to women in T1. In this predominantly NHB and Hispanic cohort, moderate maternal glycemia without PDM/GDM was associated with higher odds of HBW and HDP, even more strongly among NHB women. If confirmed, a review of current guidelines of glucose screening and risk stratification in pregnancy may be warranted.
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spelling pubmed-92245442022-06-24 Maternal Glycemic Spectrum and Adverse Pregnancy and Perinatal Outcomes in a Multiracial US Cohort Kwapong, Yaa Adoma Boakye, Ellen Wang, Guoying Hong, Xiumei Lewey, Jennifer Mamas, Mamas Andreas Wu, Pensee Blaha, Michael Joseph Nasir, Khurram Hays, Allison Gamboa Blumenthal, Roger Scott Wang, Xiaobin Sharma, Garima J Cardiovasc Dev Dis Article Diabetes mellitus (pregestational (PDM) and gestational (GDM)) is associated with adverse pregnancy outcomes (APOs). However, studies exploring the association of APOs with maternal glycemia among women without PDM/GDM are limited. We utilized data from 4119 women (307—PDM; 582—GDM; 3230—non-PDM/GDM) in the Boston Birth Cohort (1998–2016). Women in the non-PDM/GDM group were subdivided by tertiles of 1 h, 50 g oral glucose load test at 24–32 weeks: T1: 50–95 mg/dL (n = 1166), T2: 96–116 mg/dL (n = 1151), T3: 117–201 mg/dL (n = 913). Using multivariable logistic regression, we examined the association of maternal glycemia with APOs—preterm birth (PTB) and hypertensive disorders of pregnancy (HDP)—and adverse perinatal outcomes—high birth weight (HBW), cesarean section (CS), and sub-analyses by race-ethnicity. Compared to women in T1, women in T2 and T3 had a higher prevalence of pre-existing hypertension (T1: 2.8% vs. T2: 5.2% vs. T3: 6.3%) and obesity (T1: 13.3% vs. T2: 18.1% vs. T3: 22.9%). Women in T2 and T3 had higher odds of HBW (adjusted odds ratio aOR T2: 1.47 [1.01–2.19] T3: 1.68 [1.13–2.50]) compared to women in T1. Additionally, women in T2, compared to T1, had higher odds of HDP (aOR 1.44 [1.10–1.88]). Among non-Hispanic Black (NHB) women, those in T2 and T3 had higher odds of HDP compared to T1 (aOR T2 1.67 [1.13–2.51]; T3: 1.68 [1.07–2.62]). GDM and PDM were associated with higher odds of HBW, CS, PTB, and HDP, compared to women in T1. In this predominantly NHB and Hispanic cohort, moderate maternal glycemia without PDM/GDM was associated with higher odds of HBW and HDP, even more strongly among NHB women. If confirmed, a review of current guidelines of glucose screening and risk stratification in pregnancy may be warranted. MDPI 2022-06-04 /pmc/articles/PMC9224544/ /pubmed/35735808 http://dx.doi.org/10.3390/jcdd9060179 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kwapong, Yaa Adoma
Boakye, Ellen
Wang, Guoying
Hong, Xiumei
Lewey, Jennifer
Mamas, Mamas Andreas
Wu, Pensee
Blaha, Michael Joseph
Nasir, Khurram
Hays, Allison Gamboa
Blumenthal, Roger Scott
Wang, Xiaobin
Sharma, Garima
Maternal Glycemic Spectrum and Adverse Pregnancy and Perinatal Outcomes in a Multiracial US Cohort
title Maternal Glycemic Spectrum and Adverse Pregnancy and Perinatal Outcomes in a Multiracial US Cohort
title_full Maternal Glycemic Spectrum and Adverse Pregnancy and Perinatal Outcomes in a Multiracial US Cohort
title_fullStr Maternal Glycemic Spectrum and Adverse Pregnancy and Perinatal Outcomes in a Multiracial US Cohort
title_full_unstemmed Maternal Glycemic Spectrum and Adverse Pregnancy and Perinatal Outcomes in a Multiracial US Cohort
title_short Maternal Glycemic Spectrum and Adverse Pregnancy and Perinatal Outcomes in a Multiracial US Cohort
title_sort maternal glycemic spectrum and adverse pregnancy and perinatal outcomes in a multiracial us cohort
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9224544/
https://www.ncbi.nlm.nih.gov/pubmed/35735808
http://dx.doi.org/10.3390/jcdd9060179
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