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  • Chen, ShuyunDepartment of Global Public Health, Karolinska Institutet, Stockholm, Sweden (författare)

Random capillary glucose levels throughout pregnancy, obstetric and neonatal outcomes, and long-term neurodevelopmental conditions in children : a group-based trajectory analysis.

  • Artikel/kapitelEngelska2023

Förlag, utgivningsår, omfång ...

  • BioMed Central (BMC),2023
  • electronicrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:gih-7733
  • https://urn.kb.se/resolve?urn=urn:nbn:se:gih:diva-7733URI
  • https://doi.org/10.1186/s12916-023-02926-3DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-212478URI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:153225665URI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

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  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • BACKGROUND: Gestational diabetes mellitus (GDM) is associated with both short- and long-term risks, although it is unknown if risks vary by severity, timing, and duration of gestational hyperglycemia. We aimed to identify trajectories of random capillary glucose (RCG) levels throughout pregnancy and assess their associations with both obstetric/neonatal outcomes and children's risk of neurodevelopmental conditions (NDCs) (i.e., autism, intellectual disability, and attention-deficit/hyperactivity disorders [ADHD]).METHODS: A population-based cohort study was conducted involving 76,228 children born to 68,768 mothers without pregestational diabetes. Group-based trajectory modeling was utilized to identify distinct glucose trajectories across RCG values throughout the course of pregnancy. The associations between these trajectory groups and obstetric/neonatal outcomes as well as children's NDCs were then assessed using generalized estimating equation models with a logit link. The Benjamini-Hochberg (BH) procedure was employed to adjust P-values for multiple comparisons, controlling the false discovery rate (FDR).RESULTS: Five distinct glucose trajectory groups were identified, each with varying percentages diagnosed with GDM. Their associations with obstetric/neonatal outcomes as well as children's NDCs varied. For example, when compared to the "Persistently Low" group, other groups exhibited varying degrees of increased risk for large-for-gestational-age babies, with the exception of the "High in Early Pregnancy" group. Compared to the "Persistently Low" group, all other trajectory groups were associated with NDC outcomes, except the "High in Mid-Pregnancy" group. However, none of the associations with offspring NDCs remained significant after accounting for the FDR correction.CONCLUSIONS: Persistent high glucose levels or moderately elevated glucose levels throughout pregnancy, as well as transient states of hyperglycemia in early or mid-pregnancy, were found to be associated with increased risks of specific obstetric and neonatal complications, and potentially offspring NDCs. These risks varied depending on the severity, timing, duration, and management of hyperglycemia. The findings underscore the need for continuous surveillance and individualized management strategies for women displaying different glucose trajectories during pregnancy. Limitations such as potential residual confounding, the role of mediators, and small sample size should be addressed in future studies.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Persson, MargaretaUmeå universitet,Institutionen för omvårdnad,Umeå University, Umeå, Sweden(Swepub:umu)mtapen02 (författare)
  • Wang, RuiGymnastik- och idrottshögskolan,Institutionen för fysisk aktivitet och hälsa,The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden; Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden(Swepub:gih)rui.wang (författare)
  • Dalman, ChristinaKarolinska Institutet,Karolinska Institutet, Stockholm, Sweden (författare)
  • Lee, Brian KKarolinska Institutet,Karolinska Institutet, Stockholm, Sweden; Drexel University School of Public Health, Philadelphia, PA, USA.; A.J. Drexel Autism Institute, Philadelphia, PA, USA (författare)
  • Karlsson, HåkanKarolinska Institutet,Karolinska Institutet, Stockholm, Sweden (författare)
  • Gardner, Renee MKarolinska Institutet,Karolinska Institutet, Stockholm, Sweden (författare)
  • Department of Global Public Health, Karolinska Institutet, Stockholm, SwedenInstitutionen för omvårdnad (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:BMC Medicine: BioMed Central (BMC)21:11741-7015

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