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01-11-2021 | Gestational Diabetes | Original Article

Identification of maternal continuous glucose monitoring metrics related to newborn birth weight in pregnant women with gestational diabetes

Authors: Song-Ying Shen, Justina Žurauskienė, Dong-Mei Wei, Nian-Nian Chen, Jin-Hua Lu, Ya-Shu Kuang, Hui-Hui Liu, Jean-Baptiste Cazier, Xiu Qiu

Published in: Endocrine | Issue 2/2021

Abstract

Purpose

To identify the specific glucose metrics derived from maternal continuous glucose monitoring (CGM) data, which were associated with a higher percentile of offspring birth weight.

Methods

In this cohort study, we recruited singleton pregnant women with GDM who underwent CGM for 5–14 days at a mean of 28.8 gestational weeks between Jan 2017 and Nov 2018. Commonly used single summary glucose metrics of glucose exposure (including mean 24-h, daytime, and nighttime glucose level) and variability (including J-index and mean amplitude of glycaemic excursions) were derived from CGM data. A novel comprehensive glucose metric—hours per-day spent in a severe variability glucose mode (HSSV)—was identified using the spectral clustering method, which reflects both glucose level and variability. Multiple linear regression models were used to estimate the associations of sex- and gestational age-adjusted birth weight percentile with CGM parameters.

Results

Ninety-seven women comprising 127,279 glucose measurements were included. Each 1-SD increase in maternal nighttime mean glucose level and HSSV was associated with 6.0 (95% CI 0.4, 11.5) and 6.3 (95% CI 0.4, 12.2) percentage points increase in birth weight percentile, respectively. No associations were found between other glucose metrics and birth weight percentile.

Conclusion

Nighttime mean glucose level has a comparable effect size to HSSV in association with fetal growth, suggesting that endogenous hyperglycemia might drive the association between maternal hyperglycemia and birth weight. Further studies need to examine the effect of lowering nighttime glucose level and/or HSSV on preventing fetal overgrowth in GDM women.

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Title: Identification of maternal continuous glucose monitoring metrics related to newborn birth weight in pregnant women with gestational diabetes
Authors: Song-Ying Shen
Justina Žurauskienė
Dong-Mei Wei
Nian-Nian Chen
Jin-Hua Lu
Ya-Shu Kuang
Hui-Hui Liu
Jean-Baptiste Cazier
Xiu Qiu
Publication date: 01-11-2021
Publisher: Springer US
Keywords: Gestational Diabetes
Gestational Diabetes
Hyperglycemia
Published in: Endocrine / Issue 2/2021
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-021-02787-x

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Obesity Clinical Trial Summary

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