Adverse maternal and neonatal outcomes in pregnant women with abnormal glucose metabolism

Abstract Aims To assess the prevalence and risk of adverse perinatal outcomes in pregnant women with abnormal glucose metabolism. Methods 3269 Chinese pregnant women with singleton delivery were studied, including 787 diagnosed as gestational diabetes mellitus (GDM), 115 pregnancy with diabetes (PWD), and 2367 normal glucose tolerance (NGT). The prevalence and risk of adverse maternal and fetal outcomes were compared and assessed among the three groups, and the related risk factors of the glucose metabolism for adverse pregnancy outcomes were evaluated by binary logistic regression. Results Compared to NGT, maternal GDM and PWD faced increased risk of adverse perinatal outcomes such as pregnancy-induced hypertension (odds ratio (OR) 1.78 [95% confidence interval (CI): 1.17-2.72]; 4.31 [95% CI: 2.32-7.98]), low birth weight (OR 1.51 [95% CI: 1.01-2.28]; 4.05 [95% CI: 2.17-7.55]). And PWD group exhibited remarkably higher risk for preterm delivery (OR 2.88 [95% CI: 1.68-4.94]) and stillbirth (OR 7.78 [95% CI: 2.44-24.84]) than other two groups. The increased fasting insulin and glycated hemoglobin A1c were successively independent risk factors for maternal and neonatal adverse outcomes. Conclusions Gestational abnormal glucose metabolism is associated with the remarkably increased risk of adverse perinatal outcomes, and PWD has higher risk of adverse perinatal outcomes than GDM.