Mild and non-persistent fasting plasma glucose elevation in the first trimester of pregnancy is not associated with increased risk of gestational diabetes mellitus and adverse pregnancy outcomes.

OBJECTIVE

To evaluate pregnancy outcomes in women with early gestational diabetes mellitus (eGDM) diagnosed by mild elevation of fasting plasma glucose (FPG) in the first trimester.

SUBJECTS AND

METHODS

This prospective cohort study included 114 pregnant women with first trimester FPG <100 mg/dL (5.6 mmol/L). Women with FPG ≥92 mg/dL (5.1 mmol/L) and <100 mg/dL (5.6 mmol/L) were classified as having eGDM, and FPG was reassessed after approximately 3-4 weeks. Women whose repeated FPG was <92 mg/dL (5.1 mmol/L) were assigned to Group 1 (G1; n = 33) and did not receive eGDM treatment. These participants underwent an oral glucose tolerance test (OGTT) between 24-28 weeks of gestation and, depending on the results, initiated treatment as indicated. Women with eGDM and a second FPG 92-125 mg/dL (5.1-6.9 mmol/L) were assigned to Group 2 (G2; n = 31) and immediately started eGDM treatment. The control group (G3; n = 50) was composed by pregnant women with FPG <92 mg/dL (5.1 mmol/L) in the first trimester.

RESULTS

G1 and G3 had lower pre-pregnancy body mass index, less chronic hypertension, lower rates of GDM history, and lower multiparity compared to G2. There was no significant difference in GDM diagnosis by OGTT between G1 and G3 (27.3% vs. 20.0%, p = 0.594). G3 gained more weight (10.2 ± 7.6 kg, 7.5 ± 6.4 kg, and 13.5 ± 6.1 kg for G1, G2, and G3, respectively; p = 0.001). Other outcomes between G1 and G3 were similar.

CONCLUSION

Women with eGDM diagnosed by mild, non-persistent FPG elevation in the first trimester had similar outcomes to those with normal early FPG.