Effect Of Fasting Blood Glucose Before Pregnancy On Gestational Diabetes

Objectives To investigate the effect of fasting plasma glucose levels before pregnancy on gestational diabetes mellitus.Methods A prospective cohort study was conducted with a total of 1118 women who participated in the Kailuan Employee Health Checkup from 2006 as the starting time to2017 as the ending time,and had complete data on fasting glucose in the two years prior to pregnancy,and had their first pregnancy and singleton.19 women with previous history of diabetes were excluded,and a total of 1099 women were finally included in the study.The observation subjects were divided into 3 groups according to the trichotomies of pre-pregnancy fasting glucose levels.The data of normal distribution were expressed as Mean±SD,and the comparison between groups was performed by ANOVA.The data of measures with skewed distribution were expressed as Median（IQR）,and one-sample nonparametric test was used for comparison between groups.The information on counts was expressed as（n,%）,and the chi-square test was used for comparison between groups.Multi-factor linear regression was used to analyze the correlation between pre-pregnancy fasting glucose and prenatal fasting glucose,and multi-factor Logistic regression was used to analyze the effect of pre-pregnancy fasting glucose on GDM,and the difference was considered statistically significant at P<0.05（two-sided）.Results 1 The observation subjects were equally divided into three groups according to the pre-pregnancy fasting glucose level,with 363,365 and 371 cases in each group,respectively.The prenatal prevalence of GDM in each group was 8.26%,10.96%and15.09%,with statistically significant differences between the groups（P=0.014）.2According to the multifactorial linear regression analysis,after correcting for confounding factors such as age at delivery and body mass index,it was found that every 1mmol·L^-1change in fasting blood glucose before pregnancy resulted in a 0.14mmol·L^-1 increase in prenatal fasting blood glucose.In addition,the VIF values of each variable in the model were all<10.There is no collinearity between the variables.3 Multivariate Logistic regression analysis,after adjusting for various confounding factors,compared with the first decile of fasting blood glucose before pregnancy,the risk of developing GDM in the third decile of fasting blood glucose before pregnancy was 1.93（95%CI:1.15-3.25）4 Increase the age of pregnancy（OR:1.08,95%CI:1.01-1.15,P<0.05）and increase in BMI（OR:1.38,95%CI:1.03-1.85,P<0.05）are at risk for gestational diabetesConclusions 1 Elevated fasting blood glucose levels before pregnancy is a risk factor for GDM.2 Fasting blood glucose in the first 2 years of pregnancy was still positively correlated with fasting blood glucose during pregnancy,and there was a linear relationship between the two.3 Increasing the age of pregnancy and BMI are risk factors for the development of GDM.Figure 0;Table 4;Reference 166...