TY - JOUR
T1 - Maternal Glycemic Spectrum and Adverse Pregnancy and Perinatal Outcomes in a Multiracial US Cohort
AU - Kwapong, Yaa Adoma
AU - Boakye, Ellen
AU - Wang, Guoying
AU - Hong, Xiumei
AU - Lewey, Jennifer
AU - Mamas, Mamas Andreas
AU - Wu, Pensee
AU - Blaha, Michael Joseph
AU - Nasir, Khurram
AU - Hays, Allison Gamboa
AU - Blumenthal, Roger Scott
AU - Wang, Xiaobin
AU - Sharma, Garima
N1 - Funding Information:
Funding: The Boston Birth Cohort (the parent study) was supported in part by the National Insti‐ tutes of Health (NIH) grants (2R01HD041702, R01HD086013, R01HD098232, R01 ES031272, and R01ES031521); and the Health Resources and Services Administration (HRSA) of the US
Funding Information:
Department of Health and Human Services (HHS) (UJ2MC31074). Sharma is funded by the Blu‐ menthal Scholarship in Preventive Cardiology at the Ciccarone Center. Lewey is funded by National Heart, Lung and Blood Institute grant K23HL153667. No financial disclosures were reported by the authors of this paper.
Funding Information:
The Boston Birth Cohort (the parent study) was supported in part by the National Institutes of Health (NIH) grants (2R01HD041702, R01HD086013, R01HD098232, R01 ES031272, and R01ES031521); and the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) (UJ2MC31074). Sharma is funded by the Blu-menthal Scholarship in Preventive Cardiology at the Ciccarone Center. Lewey is funded by National Heart, Lung and Blood Institute grant K23HL153667. No financial disclosures were reported by the authors of this paper.
Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2022/6/4
Y1 - 2022/6/4
N2 - 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 out-comes—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 pre-dominantly 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 war-ranted.
AB - 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 out-comes—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 pre-dominantly 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 war-ranted.
KW - adverse pregnancy outcomes
KW - cardiovascular risk
KW - gestational diabetes
KW - glycemia
UR - http://www.scopus.com/inward/record.url?scp=85131896740&partnerID=8YFLogxK
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U2 - 10.3390/jcdd9060179
DO - 10.3390/jcdd9060179
M3 - Article
C2 - 35735808
AN - SCOPUS:85131896740
SN - 2308-3425
VL - 9
JO - Journal of Cardiovascular Development and Disease
JF - Journal of Cardiovascular Development and Disease
IS - 6
M1 - 179
ER -