Journal of Diabetes Research

Review Article

High Fasting Plasma Glucose during Early Pregnancy: A Review about Early Gestational Diabetes Mellitus

Table 1

Data considering prognosis of early fasting plasma glucose, of early gestational diabetes mellitus, and of strategies including early screening for gestational diabetes mellitus or not.


Reference	n	Population	Screening methods for glycemic disorders	Predictive factors of eGDM	Care and differences during pregnancy (eGDM versus remaining)	Prognosis of eGDM (adjusted)

Fasting plasma glycemia & prognosis
Riskin-Mashiah et al., 2009 [14]	6129 women	Retrospective Israel	FPG measurement at 9.5 (7.6–11.6) GW classified in 7 HAPO categories	NA	NA	Late GDM development ↑ LGA/macrosomia ↑ Cesarean delivery ↑
Liu et al., 2014 [36]	2284 women	Retrospective China	FPG at first antenatal visit (17.4 ± 4.6 GW)	NA	NA	Late GDM development ↑ Neonatal birth weight ↑
eGDM & prognosis
Bartha et al., 2000 [24]	50 eGDM versus 133 regular GDM (24–28 WG)	Retrospective Case control Spain	Women with risk factors O’Sullivan then 100 g OGTT	Age ↑ BMI ↑ Hypertension ↑	GWG ↓ Insulin therapy ↑	Total preeclampsia ↑ Oligohydramnios ↓ Neonatal hypoglycemia ↑ Perinatal death ↑ Prematurity, fetal anomalies, cesarean section, SGA, macrosomia, NICU =
Hawkins et al., 2008 [23]	339 eGDM (<24 WG) versus 2257 regular GDM	Retrospective Case control United States	Diet-treated GDM Early screening in women with risk factors O’Sullivan then 100 g OGTT	Age ↑ BMI ↑ Multiparity ↑	DIET ONLY (insulin-treated women were excluded) Better decrease in fasting plasma value during follow up for eGDM group	Preeclampsia ↑ Shoulder dystocia ↑ Macrosomia ↑ Hyperbilirubinemia ↑ Shoulder dystocia, cesarean section, NICU, neonatal death =
Seshiah et al., 2008 [44]	120 NGT versus 87 GDM < 12 WG versus 18 GDM 13–23 WG versus 15 GDM 24–30 WG versus 18 GDM > 30 WG	Retrospective Case control India	Women with family history of diabetes and bad obstetric history 75 g OGGT: 2 h PG > 140 mg/dL	FPG, 2 h PG, and HbA1c are the highest in women with GDM < 12 GW	Unknown	Birth weight GDM < 12 GW lower than birth weight GDM > 30 GW
Easmin et al., 2015 [26]	60 eGDM (<24 WG) versus 60 regular GDM (24–32 WG)	Prospective observational Case control Bangladesh	Unknown	BMI ↑ Family history of diabetes ↑	Insulin therapy ↑	Preeclampsia ↑ NICU ↑ Neonatal hypoglycemia ↑ Hyperbilirubinemia, asphyxia, perinatal death =
Boriboonhirunsarn and Kasempipatchai, 2015 [25]	142 women with eGDM (<20 GW) versus 120 women with regular GDM	Thailand 2014	Women with risk factors O’Sullivan then 100 g OGTT in early and late pregnancies	Age ↑ Previous history of GDM ↑ Multiparity ↑	GWG↓ Insulin therapy↑ Better glycemic control	Term, preeclampsia, cesarean delivery, macrosomia, hyperbilirubinemia =
Sweeting et al., 2016 [21]	3493 GDM ≥ 24 GW versus 1247 GDM 12–23 GW versus 68 GDM < 12 GW versus 65 preexisting diabetes	Retrospective Case control	Early screening only in women with risk factors ADIPS criteria	Age ↑ BMI ↑ Family history of diabetes ↑ Multiparity ↑	GWG↓ Insulin therapy↑ Earlier insulin therapy↑ Maximum daily insulin dose↑	Gradient in 4 groups Preterm delivery ↑ Cesarean section ↑ Hypertensive disorders ↑ Macrosomia ↑ Hyperbilirubinemia ↑ Respiratory distress syndrome ↑
Regnault et al., 2016 [17]	18,299 women with eGDM (<22 GW) versus 37,551 women with GDM (22–30 GW)	From the 788,494 women who delivered in France in 2013	Early and regular screening in case of risk factors IADPSG criteria	No data	Insulin therapy ↑	Cesarean delivery ↑ LGA ↑
Screening strategy including early screening & prognosis
Alunni et al., 2015 [18]	First period: 147 women with GDM after 24 GW versus second period: 175 GDM women with early and, if negative screening, late screening	From 2652 women who delivered between 2010 and 2012 United States	First period: O’Sullivan and 100 g OGTT after 24 GW Second period: early screening FPG and HbA1c; 75 g OGTT (IADPSG)	BMI ↓ during the second period	Comparison between first and second periods Insulin = Comparison during the second period (eGDM versus regular GDM) Insulin therapy ↑	Term = Cesarean delivery = Macrosomia = SGA =
Hong et al., 2016 [45]	112 women screened early (including 85 with early GDM and 27 with regular GDM) versus 457 women with regular GDM who were not tested earlier	569 women with risk factors for GDM United States	Early screening only in case of risk factors In early and regular screening: O’Sullivan then 100 g OGTT	Early screening strategy Private insurance ↑ History of GDM ↑ Chronic hypertension ↑ BMI ↑	Insulin therapy ↑	Early screening strategy Cesarean section = Preeclampsia = SGA and LGA = Birth injury = Preterm delivery ↑

2h-PG: 2-hour plasma glucose; ADIPS: Australasian Diabetes in Pregnancy Society; BMI: body mass index; eGDM: early gestational diabetes mellitus; GDM: gestational diabetes mellitus; GWG: gestational weight gain; HAPO: hyperglycemia and adverse pregnancy outcome; LGA: large for gestational age; NA: nonapplicable; NICU: neonatal intensive care unit; OGTT: oral glucose tolerance test; SGA: small for gestational age; WG: weeks of gestation; =: similar; ↓: decreased or lower; ↑: increased or higher. References where multivariate analyses were performed.