Gestational diabetes & diabetes in pregnancy
Relationship Between Early-Pregnancy Glycemia and Adverse Outcomes: Findings From the TOBOGM Study
Authors' conclusion
There is a continuous positive association between early-pregnancy OGTT glucose and complications. In individuals with hyperglycemia risk factors, only the high-glycemic-band 1-h glucose corresponded to increased risk of major perinatal complications.
Study context
- Population
- Pregnant individuals with risk factors for hyperglycemia; 2-h 75-g oral glucose tolerance test (OGTT) at <20 weeks' gestation; early treated hyperglycemia excluded from primary analysis
- Participants
- 3,645 individuals
- Comparison
- Early-pregnancy OGTT glucose
Methodological detailsinternational, multicenter, OGTT at (mean ± SD) 15.6 ± 2.5 weeks
- International
- Multicenter
- OGTT at (mean ± SD) 15.6 ± 2.5 weeks
Primary result
As reported in the abstract
Late gestational diabetes mellitus (GDM) per 1-SD increase in glucose
Fasting glucose, aOR
2.04
95% CI 1.82–2.27
1-h glucose, aOR (2.72-3.43)
3.05
2-h glucose, aOR (1.99-2.45)
2.21
Further findings
Perinatal composite per 1-SD increase in glucose
- 1-h glucose, aOR
- 1.15 (95% CI 1.04-1.26)
- 2-h glucose, aOR (1.04-1.25)
- 1.14
Large-for-gestational-age offspring per 1-SD increase in glucose
- 1-h glucose, aOR (1.06-1.31)
- 1.18
- 2-h glucose, aOR (1.01-1.25)
- 1.26
Cesarean section and neonatal hypoglycemia
- Significant associations between 1-h glucose and cesarean section and between fasting and 2-h glucose and neonatal hypoglycemia
Perinatal composite, categorical analysis
- Only high-band 1-h glucose (≥10.6 mmol/L [191 mg/dL]) predicted the perinatal composite
Original publication
Relationship Between Early-Pregnancy Glycemia and Adverse Outcomes: Findings From the TOBOGM Study. Diabetes Care. Published 31 July 2024. doi:10.
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