Due to the increasing rate of undiagnosed DM among pregnant women in early gestation, the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) and the World Health Organization (WHO) have recommended first-trimester screening to identify overt diabetes in pregnancy (ODIP) ( 1). It is widely recognized that untreated overt DM during pregnancy is strongly associated with adverse feto-maternal and neonatal outcomes ( 7). Likewise, the results of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study have confirmed a continuous association between adverse pregnancy outcomes and maternal glucose levels that are that are less severe than those in overt diabetes mellitus (DM) ( 6). During this time, placenta produces diabetogenic hormones such as human placental lactogen which can lead to progressive insulin resistance and elevated blood glucose levels in individuals with insufficient insulin production to maintain euglycemia ( 5). Traditionally, GDM screening and diagnosis have been based on oral glucose tolerance test (OGTT) in the second trimester of pregnancy ( 3, 4). Gestational diabetes (GDM) is one of the most common endocrinopathies during gestation ( 1, 2).
Second trimester prenatal visits trial#
Therefore, extrapolating the FPG cut-off point of the second trimester to the first –which has been proposed by the IADPSG, might therefore not be appropriate.Ĭlinical Trial Registration:, identifier IRCT138707081281N1. There were no statistically significant differences in the adjusted risks of adverse pregnancy outcomes, including macrosomia, primary C-S, preterm birth, hyperbilirubinemia, preeclampsia, NICU-admission, birth trauma, and LBW both groups.Ĭonclusions: It is found that treating women with first-trimester FPG values of 5.1-5.6 mmol/l could not improve adverse pregnancy outcomes including macrosomia, Primary C-S, Preterm birth, hypoglycemia, hypocalcemia, preeclampsia, NICU admission, Birth trauma and LBW. Results: The mean maternal age and BMI of pregnant women in both study groups were similar. A modified-Poisson-regression for binary outcome data with a log link function and robust error variance was used to RR (95%CI) for the associations between GDM status and incidence of pregnancy outcomes. Macrosomia/large for gestational age (LGA) and primary cesarean-section (C-S) were considered as primary-outcomes. All pregnant women with FPG values range 5.1-5.6 mmol/l in the first trimester of gestation were included in the present study (n=3297) and classified to either the (i) intervention group who received treatment for GDM along with usual prenatal care (n=1,198), (ii) control group who received usual-prenatal-care (n=2,099). Methods: We performed a secondary-analysis of a randomized community non-inferiority trial of gestational diabetes mellitus (GDM) screening. Objectives: The aim of the study was to investigate the effect of treatment on pregnancy outcomes among women who had fasting plasma glucose (FPG) 5.1-5.6 mmol/l in the first trimester of pregnancy. 12Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.11Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.10Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.9Family Health Department, Ministry of Health and Medical Education, Tehran, Iran.8Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.7Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran.
6Faculty of Medicine, Shahed University, Tehran, Iran.5Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.4Infertility and Cell Therapy Office, Transplant & Disease Treatment Center, Ministry of Health and Medical Education, Tehran, Iran.3Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.2Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.1Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Fahimeh Ramezani Tehrani 1, Farshad Farzadfar 2, Farhad Hosseinpanah 3, Maryam Rahmati 1, Faegheh Firouzi 1, Mehrandokht Abedini 4, Farzad Hadaegh 5, Majid Valizadeh 3, Farahnaz Torkestani 6, Davood Khalili 5, Masoud Solaymani-Dodaran 7, Razieh Bidhendi-Yarandi 8, Marzieh Bakhshandeh 9, Afshin Ostovar 10, Marzieh Rostami Dovom 1, Mina Amiri 1, Fereidoun Azizi 11 and Samira Behboudi-Gandevani 12*
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