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

AimTo elucidate risk factors associated with adverse perinatal outcomes in early‐gestational diabetes mellitus (GDM).Materials and MethodsA 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.ResultsPre‐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.ConclusionsEarly‐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.