Latest Advances in the Associations of Early- and Mid-pregnancy Fasting Plasma Glucose with Pregnancy Outcome

doi:10.12114/j.issn.1007-9572.2021.02.094

Abstract

Abstract:

Gestational diabetes mellitus (GDM) , gestational hypertension, macrosomia, low birth weight, and premature delivery can directly affect short- and long-term maternal and infant health. Fasting plasma glucose can be obtained conveniently and rapidly during pregnancy. Numerous studies have verified that early- and mild-pregnancy fasting plasma glucose are associated with GDM, large for gestational age, and neonatal birth weight. But there is still some controversy about whether they associate with gestational hypertension and cesarean section. Furthermore, further studies are needed to examine their long-term influence on related diseases of pregnant women and their offspring in childhood and adulthood. This paper gives a summary of recent advances in the associations of early- and mid-pregnancy fasting plasma glucose with pregnancy outcome, providing a reference for future studies that profoundly explore relevant issues.

Key words: Pregnancy, Plasma glucose, Glucose tolerance test, Pregnancy outcome, Review

摘要：

妊娠期糖尿病、妊娠期高血压、巨大儿、低出生体质量儿、早产等直接影响母婴近、远期健康。妊娠期检测空腹血糖方便、快捷，国内外多项研究发现，妊娠早中期空腹血糖与妊娠期糖尿病、大于胎龄儿的发生及新生儿出生体质量等存在相关性，但其对妊娠期高血压、剖宫产等的影响尚存在一定争议。同时，妊娠早中期空腹血糖对特定特征的孕妇及其子代儿童期、成年期相关疾病的远期影响还需进一步探讨。本文主要总结、分析了妊娠早中期空腹血糖对妊娠结局的影响，以期为今后深入研究妊娠期血糖对母婴近、远期健康的影响提供参考。

关键词: 妊娠, 血糖, 葡糖耐量试验, 妊娠结局, 综述

Jinfeng GAO,Xiaoping YU,Ju ZHANG. Latest Advances in the Associations of Early- and Mid-pregnancy Fasting Plasma Glucose with Pregnancy Outcome[J]. Chinese General Practice, 2022, 25(12): 1519-1523. DOI: 10.12114/j.issn.1007-9572.2021.02.094.
高锦凤,余小平,张琚. 妊娠早中期空腹血糖对妊娠结局影响的研究进展[J]. 中国全科医学, 2022, 25(12): 1519-1523. DOI: 10.12114/j.issn.1007-9572.2021.02.094.

References 31

[1]	International Diabetes Federation. IDF Diabetes Atlas[R]. 9th ed. Brussels：International Diabetes Federation，2019.
[2]	梁一，李丹婷，陈梦雪，等. 中国西南地区妇女孕前体质量指数、孕期增重与妊娠期糖尿病关系的前瞻性队列研究[J]. 四川大学学报（医学报），2019，50(1)：83-87. DOI：10.13464/j.scuxbyxb.2019.01.016.
[3]	ZHU W W, YANG H X, WANG C，et al. High prevalence of gestational diabetes mellitus in Beijing：effect of maternal birth weight and other risk factors[J]. Chin Med J（Engl），2017，130(9)：1019-1025. DOI：10.4103/0366-6999.204930.
[4]	中华医学会妇产科学分会产科学组. 孕前和孕期保健指南（2018）[J]. 中华妇产科杂志，2018，53(1)：7-13. DOI：10.3760/cma.j.issn.0529-567x.2018.01.003.
[5]	ZHU W W, YANG H X, WEI Y M，et al. Evaluation of the value of fasting plasma glucose in the first prenatal visit to diagnose gestational diabetes mellitus in China[J]. Diabetes Care，2013，36(3)：586-590. DOI：10.2337/dc12-1157.
[6]	耿小妍. 妊娠早期空腹血糖与妊娠期糖尿病发生的关系[J]. 中国继续医学教育，2020，12(8)：96-99. DOI：10.3969/j.issn.1674-9308.2020.08.037.
[7]	喻茜，牛晓虎，冯佩，等. 妊娠早期空腹血糖对妊娠期糖尿病的影响[J]. 实用预防医学，2016，23(10)：1207-1210. DOI：10.3969/j.issn.1006-3110.2016.10.018.
[8]	COSSON E, VICAUT E, SANDRE-BANON D，et al. Initially untreated fasting hyperglycaemia in early pregnancy：prognosis according to occurrence of gestational diabetes mellitus after 22 weeks' gestation：a case-control study[J]. Diabet Med，2020，37(1)：123-130. DOI：10.1111/dme.14141.
[9]	中华医学会妇产科学分会产科学组，中华医学会围产医学分会妊娠合并糖尿病协作组. 妊娠合并糖尿病诊治指南（2014）[J]. 中华妇产科杂志，2014，49(8)：561-569. DOI：10.3760/cma.j.issn.0529-567x.2014.08.001.
[10]	HAO M, LIN L. Fasting plasma glucose and body mass index during the first trimester of pregnancy as predictors of gestational diabetes mellitus in a Chinese population[J]. Endocr J，2017，64(5)：561-569. DOI：10.1507/endocrj.EJ16-0359.
[11]	SESMILO G, PRATS P, GARCIA S，et al. First-trimester fasting glycemia as a predictor of gestational diabetes（GDM）and adverse pregnancy outcomes[J]. Acta Diabetol，2020，57(6)：697-703. DOI：10.1007/s00592-019-01474-8.
[12]	苗志荣，吴红花，张扬，等. 早孕期代谢指标对不同孕前体重妊娠期糖尿病预测的价值探讨[J].中华糖尿病杂志，2020，12(7)：462-468. DOI：10.3760/cma.j.cn115791-20200401-00189.
[13]	梁一. 早期营养干预对妊娠糖尿病高危人群影响[D]. 贵州：贵州医科大学，2016.
[14]	ROEDER H A, MOORE T R, WOLFSON M T，et al. Treating hyperglycemia in early pregnancy：a randomized controlled trial[J]. Am J Obstet Gynecol MFM，2019，1(1)：33-41. DOI：10.1016/j.ajogmf.2019.03.003.
[15]	LIU B, GENG H, YANG J，et al. Early pregnancy fasting plasma glucose and lipid concentrations in pregnancy and association to offspring size：a retrospective cohort study[J]. BMC Pregnancy Childbirth，2016，16：56. DOI：10.1186/s12884-016-0846-7.
[16]	顾萍，喻茜，冯佩，等. 孕早期空腹血糖对巨大儿发生的预测价值[J]. 中国妇幼保健，2019，34(17)：3949-3951. DOI：10.7620/zgfybj.j.issn.1001-4411.2019.17.24.
[17]	MAÑÉ L, FLORES-LE ROUX J A, PEDRO-BOTET J，et al. Is fasting plasma glucose in early pregnancy a better predictor of adverse obstetric outcomes than glycatedhaemoglobin？[J]. Eur J Obstet Gynecol Reprod Biol，2019，234：79-84. DOI：10.1016/j.ejogrb.2018.12.036.
[18]	BENHALIMA K, VAN CROMBRUGGE P, MOYSON C，et al. Women with mild fasting hyperglycemia in early pregnancy have more neonatal intensive care admissions[J]. J Clin Endocrinol Metab，2021，106(2)：e836-854. DOI：10.1210/clinem/dgaa831.
[19]	HAPO Study Cooperative Research Group，METZGER B E，LOWE L P，et al. Hyperglycemia and adverse pregnancy outcomes[J].New Engl J Med，2008，358(19)：1991-2002. DOI：10.1056/NEJMoa0707943.
[20]	WEI Y, YANG H, ZHU W，et al. International Association of Diabetes and Pregnancy Study Group criteria is suitable for gestational diabetes mellitus diagnosis：further evidence from China[J]. Chin Med J（Engl），2014，127(20)：3553-3556. DOI：10.3760/cma.j.issn.0366-6999.20140898.
[21]	DING T T, XIANG J, LUO B R，et al. Relationship between the IADPSG-criteria-defined abnormal glucose values and adverse pregnancy outcomes among women having gestational diabetes mellitus：a retrospective cohort study[J]. Medicine（Baltimore），2018，97(43)：e12920. DOI：10.1097/MD.0000000000012920.
[22]	PAPACHATZPOULOU E, CHATZAKIS C, LAMBRINOUDAKI I，et al. Abnormal fasting，post-load or combined glucose values on oral glucose tolerance test and pregnancy outcomes in women with gestational diabetes mellitus[J]. Diabetes Res Clin Pract，2020，161：108048. DOI：10.1016/j.diabres.2020.108048.
[23]	SHEN S, LU J, ZHANG L，et al. Single fasting plasma glucose versus 75-g oral glucose-tolerance test in prediction of adverse perinatal outcomes：a cohort study[J]. EBio Medicine，2017，16：284-291. DOI：10.1016/j.ebiom.2017.01.025.
[24]	ZHOU Z, CHEN G, FAN D，et al. Size and shape of associations of OGTT as well as mediating effects on adverse pregnancy outcomes among women with gestational diabetes mellitus：population-based study from Southern Han Chinese[J]. Front Endocrinol（Lausanne），2020，11：135. DOI：10.3389/fendo.2020.00135.
[25]	刘石萍，邢会美，苏世萍，等. 单纯空腹血糖升高的妊娠期糖尿病患者的妊娠结局及其影响因素[J]. 中华围产医学杂志，2017，20(11)：796-800. DOI：10.3760/cma.j.issn.1007-9408.2017.11.006.
[26]	LOWE W L Jr, SCHOLTENS D M, LOWE L P，et al. Association of gestational diabetes with maternal disorders of glucose metabolism and childhood adiposity[J]. JAMA，2018，320(10)：1005-1016. DOI：10.1001/jama.2018.11628.
[27]	LOWE W L Jr, SCHOLTENS D M, KUANG A，et al. Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study（HAPO FUS）：maternal gestational diabetes mellitus and childhood glucose metabolism[J]. Diabetes Care，2019，42(3)：372-380. DOI：10.2337/dc18-1646.
[28]	LU J, ZHANG S, LI W，et al. Maternal gestational diabetes is associated with offspring's hypertension[J]. Am J Hypertens，2019，32(4)：335-342. DOI：10.1093/ajh/hpz005.
[29]	忻荣荣. 妊娠期糖尿病孕妇孕中晚期HbA1c与子代出生时及六周体格发育的相关性[D]. 呼和浩特：内蒙古医科大学，2019.
[30]	蒋新液，郭冰冰，裴晶晶，等. 妊娠期糖尿病孕妇的早期规范化管理对分娩新生儿及其随访的影响[J]. 中华妇幼临床医学杂志（电子版），2018，14(6)：711-717. DOI：10.3877/cma.j.issn.1673-5250.2018.06.014.
[31]	WEI Y, XU Q, YANG H，et al. Preconception diabetes mellitus and adverse pregnancy outcomes in over 6.4 million women：a population-based cohort study in China[J]. PLoS Med，2019，16(10)：e1002926. DOI：10.1371/journal.pmed.1002926.