Can the First Fasting Plasma Glucose Test in Pregnancy Predict Subsequent Gestational Complications?

Area of Science:

• Obstetrics and Gynecology
• Endocrinology
• Perinatal Medicine

Background:

• Gestational diabetes mellitus (GDM) poses risks to maternal and fetal well-being.
• Early identification of GDM risk factors is essential for timely intervention.
• First fasting plasma glucose (FFPG) is a potential early screening marker.

Purpose of the Study:

• To establish an optimal FFPG cut-off value for predicting GDM onset.
• To investigate the association between FFPG levels and maternal/neonatal outcomes.
• To analyze these associations in a large Caucasian population.

Main Methods:

• Retrospective analysis of 1437 pregnant women's medical records (2015-2018).
• Collected data on FFPG, oral glucose tolerance test (OGTT) results, and clinical/metabolic characteristics.
• Evaluated associations with GDM, need for insulin therapy, and fetal outcomes like large for gestational age (LGA).

Main Results:

• FFPG ≥92 mg/dl significantly predicted GDM risk (OR=1.92, p<0.001) in multivariate analysis.
• FFPG ≥92 mg/dl also predicted the need for insulin therapy in GDM patients (OR=1.88, p<0.001).
• FFPG ≥92 mg/dl was associated with LGA risk in non-GDM women (OR=2.34, p=0.014) but not in GDM women.

Conclusions:

• An FFPG level of 92 mg/dl or higher is a significant predictor of GDM diagnosis.
• This FFPG threshold also indicates an increased likelihood of requiring insulin therapy for GDM.
• Prompt GDM diagnosis and insulin initiation are vital for preventing complications.