Impact of maternal overweight/obesity and high fasting plasma glucose on adverse perinatal outcomes in early gestational diabetes mellitus

ABSTRACT Aim To elucidate risk factors associated with adverse perinatal outcomes in early‐gestational diabetes mellitus (GDM). Materials and Methods A dataset of 385 early‐GDM cases from a prospective cohort was analyzed. Early‐GDM was diagnosed if one or more of the following criteria were met: fa...

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Main Authors: Noriyuki Iwama, Maki Yokoyama, Hiroshi Yamashita, Kei Miyakoshi, Ichiro Yasuhi, Maki Kawasaki, Naoko Arata, Shiori Sato, Yuko Iimura, Waguri Masako, Haruna Kawaguchi, Naoki Masaoka, Yoshiyuki Nakajima, Yuji Hiramatsu, Takashi Sugiyama, DREAMBee Study Gestational Diabetes Mellitus Group
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:Journal of Diabetes Investigation
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Online Access:https://doi.org/10.1111/jdi.14411
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author Noriyuki Iwama
Maki Yokoyama
Hiroshi Yamashita
Kei Miyakoshi
Ichiro Yasuhi
Maki Kawasaki
Naoko Arata
Shiori Sato
Yuko Iimura
Waguri Masako
Haruna Kawaguchi
Naoki Masaoka
Yoshiyuki Nakajima
Yuji Hiramatsu
Takashi Sugiyama
DREAMBee Study Gestational Diabetes Mellitus Group
author_facet Noriyuki Iwama
Maki Yokoyama
Hiroshi Yamashita
Kei Miyakoshi
Ichiro Yasuhi
Maki Kawasaki
Naoko Arata
Shiori Sato
Yuko Iimura
Waguri Masako
Haruna Kawaguchi
Naoki Masaoka
Yoshiyuki Nakajima
Yuji Hiramatsu
Takashi Sugiyama
DREAMBee Study Gestational Diabetes Mellitus Group
author_sort Noriyuki Iwama
collection DOAJ
description ABSTRACT Aim To elucidate risk factors associated with adverse perinatal outcomes in early‐gestational diabetes mellitus (GDM). Materials and Methods A dataset of 385 early‐GDM cases from a prospective cohort was analyzed. Early‐GDM was diagnosed if one or more of the following criteria were met: fasting plasma glucose (PG) levels of 92–125 mg/dL, 1‐h PG levels ≥180 mg/dL, and 2‐h PG levels ≥153 mg/dL during a 75‐g oral glucose tolerance test before 20 weeks of gestation. Multivariate analysis was used to examine associations between candidate risk factors and a composite outcome of maternal and neonatal adverse events. Results Pre‐pregnancy overweight/obesity (pre‐pregnancy body mass index [BMI] ≥25.0 kg/m2) was significantly associated with a higher risk of the composite outcome compared with normal weight (pre‐pregnancy BMI of 18.5–24.9 kg/m2), an adjusted risk ratio (aRR) of 1.44 (95% confidence interval [CI]: 1.08–1.93), and an adjusted risk difference (aRD) of 13.6% (95% CI: 2.6–24.6%). Compared with fasting PG levels below 92 mg/dL, levels between 95 and 125 mg/dL were associated with a significantly higher risk of the composite outcome, with an aRR and aRD of 1.42 (95% CI: 1.01–1.99) and 12.9% (95% CI: 0.3–25.5%), respectively. Conclusions Early‐GDM, combined with pre‐pregnancy overweight/obesity and/or fasting PG levels of 95–125 mg/dL, is associated with a higher risk of adverse perinatal outcomes and should be prioritized for intervention.
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spelling doaj-art-c526fe2def354c84935947ba40a50fb82025-08-20T02:25:12ZengWileyJournal of Diabetes Investigation2040-11162040-11242025-04-0116474475410.1111/jdi.14411Impact of maternal overweight/obesity and high fasting plasma glucose on adverse perinatal outcomes in early gestational diabetes mellitusNoriyuki Iwama0Maki Yokoyama1Hiroshi Yamashita2Kei Miyakoshi3Ichiro Yasuhi4Maki Kawasaki5Naoko Arata6Shiori Sato7Yuko Iimura8Waguri Masako9Haruna Kawaguchi10Naoki Masaoka11Yoshiyuki Nakajima12Yuji Hiramatsu13Takashi Sugiyama14DREAMBee Study Gestational Diabetes Mellitus GroupCenter for Maternal and Perinatal Medicine Tohoku University Hospital Sendai Miyagi JapanDepartment of Obstetrics and Gynecology Ehime University Graduate School of Medicine Toon Ehime JapanDepartment of Obstetrics and Gynecology NHO Nagasaki Medical Center Omura‐City, Nagasaki JapanDepartment of Obstetrics and Gynecology International Catholic Hospital Shinjuku‐ku, Tokyo JapanDepartment of Obstetrics and Gynecology NHO Nagasaki Medical Center Omura‐City, Nagasaki JapanDepartment of Health Policy National Center for Child Health and Development Setagaya, Tokyo JapanDivision of Women’s Internal Medicine, Women’s Health Center National Center for Child Health and Development Setagaya, Tokyo JapanDivision of Women’s Internal Medicine, Women’s Health Center National Center for Child Health and Development Setagaya, Tokyo JapanDivision of Women’s Internal Medicine, Women’s Health Center National Center for Child Health and Development Setagaya, Tokyo JapanDepartment.of Obstetric Medicine Osaka Women's and Children's Hospital Izumi, Osaka JapanDepartment of Maternal Fetal Medicine Osaka Women's and Children's Hospital Izumi, Osaka JapanDepartment of Obstetrics and Gynecology Tokyo Women's Medical University Yachiyo Medical Center Yachiyo Chiba JapanDepartment of Obstetrics and Gynecology Tokyo Women's Medical University Yachiyo Medical Center Yachiyo Chiba JapanOkayama City General Medical Center Okayama City Okayama JapanDepartment of Obstetrics and Gynecology Ehime University Graduate School of Medicine Toon Ehime JapanABSTRACT Aim To elucidate risk factors associated with adverse perinatal outcomes in early‐gestational diabetes mellitus (GDM). Materials and Methods A dataset of 385 early‐GDM cases from a prospective cohort was analyzed. Early‐GDM was diagnosed if one or more of the following criteria were met: fasting plasma glucose (PG) levels of 92–125 mg/dL, 1‐h PG levels ≥180 mg/dL, and 2‐h PG levels ≥153 mg/dL during a 75‐g oral glucose tolerance test before 20 weeks of gestation. Multivariate analysis was used to examine associations between candidate risk factors and a composite outcome of maternal and neonatal adverse events. Results Pre‐pregnancy overweight/obesity (pre‐pregnancy body mass index [BMI] ≥25.0 kg/m2) was significantly associated with a higher risk of the composite outcome compared with normal weight (pre‐pregnancy BMI of 18.5–24.9 kg/m2), an adjusted risk ratio (aRR) of 1.44 (95% confidence interval [CI]: 1.08–1.93), and an adjusted risk difference (aRD) of 13.6% (95% CI: 2.6–24.6%). Compared with fasting PG levels below 92 mg/dL, levels between 95 and 125 mg/dL were associated with a significantly higher risk of the composite outcome, with an aRR and aRD of 1.42 (95% CI: 1.01–1.99) and 12.9% (95% CI: 0.3–25.5%), respectively. Conclusions Early‐GDM, combined with pre‐pregnancy overweight/obesity and/or fasting PG levels of 95–125 mg/dL, is associated with a higher risk of adverse perinatal outcomes and should be prioritized for intervention.https://doi.org/10.1111/jdi.14411Early gestational diabetes mellitusFasting plasma glucoseOverweight/obesity
spellingShingle Noriyuki Iwama
Maki Yokoyama
Hiroshi Yamashita
Kei Miyakoshi
Ichiro Yasuhi
Maki Kawasaki
Naoko Arata
Shiori Sato
Yuko Iimura
Waguri Masako
Haruna Kawaguchi
Naoki Masaoka
Yoshiyuki Nakajima
Yuji Hiramatsu
Takashi Sugiyama
DREAMBee Study Gestational Diabetes Mellitus Group
Impact of maternal overweight/obesity and high fasting plasma glucose on adverse perinatal outcomes in early gestational diabetes mellitus
Journal of Diabetes Investigation
Early gestational diabetes mellitus
Fasting plasma glucose
Overweight/obesity
title Impact of maternal overweight/obesity and high fasting plasma glucose on adverse perinatal outcomes in early gestational diabetes mellitus
title_full Impact of maternal overweight/obesity and high fasting plasma glucose on adverse perinatal outcomes in early gestational diabetes mellitus
title_fullStr Impact of maternal overweight/obesity and high fasting plasma glucose on adverse perinatal outcomes in early gestational diabetes mellitus
title_full_unstemmed Impact of maternal overweight/obesity and high fasting plasma glucose on adverse perinatal outcomes in early gestational diabetes mellitus
title_short Impact of maternal overweight/obesity and high fasting plasma glucose on adverse perinatal outcomes in early gestational diabetes mellitus
title_sort impact of maternal overweight obesity and high fasting plasma glucose on adverse perinatal outcomes in early gestational diabetes mellitus
topic Early gestational diabetes mellitus
Fasting plasma glucose
Overweight/obesity
url https://doi.org/10.1111/jdi.14411
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