Abstract

ARGERICH, María Inés; DAVID, Raúl. A.; GONZALEZ, Nadya  and  ROVIRA, Gabriela. Glucemia materna de primer trimestre de embarazo y probabilidad de padecer DG. Categorización según IMC pregestacional. Rev. Soc. Argent. Diabetes [online]. 2021, vol.55, n.3, pp.84-89. ISSN 0325-5247.

Introduction: fasting blood glucose >85 mg/dl in the first trimester of pregnancy is one of the risk factors for the development of gestational diabetes (GD). The increase in overweight and obesity in women of childbearing age, and the excessive weight gain throughout pregnancy, are predisposing to the development of this pathology leading a rol in maternal hypertriglyceridemia, favoring to fetal macrosomia. Understanding the association between these variables is important to individualize the risk and take early behaviors in order to reduce maternal/fetal complications.

Objectives: primary: determine the probability of developing GD according to fasting glycemia of the firts trimester of pregnancy (>85 mg/dl) by body mass index (BMI) category, age and maternal weight gain. Secondary: compare maternal triglyceridemia (TG) of the last trimester, fetal weight and fasting glycemia of oral glucose tolerance test (OGTT) according to BMI in patients with and without GD. Determine the prevalence of macrosomia.

Materials and methods: medical records (MR) of patients with GD from the Diabetes and Pregnancy Unit and from the Maternity Service of patients without GD from the Perrupato´s Hospital, San Martin, Mendoza. Included were: age over 18 years, complete records of MR, diagnosis of GD by OGTT. 127 MR from patients with GD and 169 MR from patients without GD were included and classified according to pre-pregnancy BMI: BMI <24.9, BMI 25-30 and BMI> 30.

Results: GD OR for category A was 15 times, for category B it was 9.2 times and for category C 10.7 times with large magnitude effect for the three categories. There were no differences between fetal weight (p=0.14, 0.36 and 0.59 respectively). fasting glycemia OGTT was significant in all categories (p=0.002;0.01 and <0.001 respectively), maternal TG in the last trimester were significant in categories A and B (p=0.04 and 0.026 res-pectively). The prevalence of macrosomia increased in relation to the increase in BMI.

Conclusions: fasting blood glucose of the first trimester is a strong predictor of DG in all evaluated categories.

Keywords : gestational diabetes; pregnancy; first trimester fasting blood glucose; macrosomia.

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