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Moms' Elevated Glucose Linked to Fetal Problems

Even at levels below diabetes, hyperglycemia associated with increased birth weight, other issues

WEDNESDAY, May 7 (HealthDay News) -- Maternal glucose levels that are elevated, but not high enough to warrant a diabetes diagnosis, are associated with increased birth weight and a marker of fetal hyperinsulemia, researchers report in the May 8 issue of the New England Journal of Medicine.

Boyd E. Metzger, M.D., of Northwestern University Feinberg School of Medicine in Chicago, and colleagues writing on behalf of the HAPO Study Cooperative Research Group, analyzed data from 25,505 pregnant women who underwent oral glucose-tolerance testing at 24 to 32 weeks of gestation. Some other participants' data was unblinded if results were diagnostic of diabetes or for other ethical and safety reasons.

The investigators found that a fasting plasma glucose level that was increased by one standard deviation (6.9 milligrams per deciliter) was associated with greater risk of birth weight above the 90th percentile (odds ratio 1.38). Increased one-hour and two-hour plasma glucose levels were also associated with this outcome. Elevations in these measurements were also associated with greater risk of cord-blood serum C-peptide level above the 90th percentile, a measurement of fetal β-cell function.

"Questions have been raised regarding the benefits of treating 'mild' gestational diabetes mellitus," the authors write. "Taken together, the current results and results of the ACHOIS trial [Australian Carbohydrate Intolerance Study in Pregnant Women] indicate that maternal hyperglycemia less severe than that used to define overt diabetes is related to clinically important perinatal disorders or problems and that their effects can be reduced by means of treatment, although a threshold for the need for treatment is not established."

Metzger and several co-authors disclose financial relationships with pharmaceutical companies including Novo-Nordisk and Takeda.

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