Exploring the relationship between maternal Continuous Glucose Monitoring "time in range" and fetal abdominal circumference in pregnant women with Type 1 Diabetes.

IF 1.7 4区 医学 Q3 OBSTETRICS & GYNECOLOGY
Liesel Woon, Tessa Glyn, Alexandra Gorelik, Rani Haj Yahya, Sarah A Price
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引用次数: 0

Abstract

Background: To explore the relationship between maternal glycaemic control and fetal abdominal circumference in pregnancies complicated by T1D.

Methods: This is a retrospective cohort study of 81 pregnant women with T1D using CGM. Inclusion criteria were T1D, CGM use, ≥2 in-house ultrasounds, and the birth of a live singleton neonate between 1st December 2019 and 1st December 2022. Linear regression analysis was used to assess the cross-sectional relationships between estimated fetal abdominal circumference (AC) on ultrasound and time in range (TIR) at matched time-points in the third trimester of pregnancy. Linear regression analysis was also used to examine whether first trimester TIR and HbA1c predicts third trimester fetal AC.

Results: At baseline, the mean ± standard deviation (SD) of the first trimester HbA1c was 7.0 ± 1.4% and mean ± SD total daily dose (TDD) insulin was 46.6 ± 21.0 units. The mean ± SD birthweight was 3367.0 ± 861.3 grams. There was no cross-sectional relationship between TIR and fetal AC at 28-, 32- or 36-week' gestation. The results of the regression analysis indicate a significant relationship between first trimester TIR (independent predictor) and fetal AC (dependent variable) at 32- and 36-weeks' gestation while controlling for maternal age, BMI, pump use, and TDD insulin (Adjβ= -0.42, 95%CI -0.80 to -0.03 and Adjβ = -0.57, 95%CI -1.02 to -0.12 at 32- and 36-weeks respectively). Although there was a significant relationship between first trimester HbA1c and fetal AC at 32-weeks' gestation (β = 3.81, 95%CI 0.29 to 7.33), the relationship was not significant after adjustment for confounders.

Conclusions: There was no cross-sectional relationship between TIR and fetal AC in the third trimester of pregnancy but first trimester TIR did predict fetal AC in late pregnancy.

探讨 1 型糖尿病孕妇的母体连续血糖监测 "在量程内的时间 "与胎儿腹围之间的关系。
背景:探讨并发 T1D 孕妇的血糖控制与胎儿腹围之间的关系:目的:探讨 T1D 并发症孕妇的血糖控制与胎儿腹围之间的关系:这是一项回顾性队列研究,研究对象为 81 名使用 CGM 的 T1D 孕妇。纳入标准为:T1D、使用 CGM、≥2 次内部超声波检查,以及在 2019 年 12 月 1 日至 2022 年 12 月 1 日期间出生活产单胎新生儿。线性回归分析用于评估超声估计胎儿腹围(AC)与妊娠三个月内匹配时间点胎儿腹围在范围内的时间(TIR)之间的横截面关系。线性回归分析还用于研究怀孕前三个月的 TIR 和 HbA1c 是否能预测怀孕后三个月的胎儿腹围:基线时,妊娠头三个月 HbA1c 的平均值(± 标准差)为 7.0 ± 1.4%,胰岛素日总剂量(TDD)的平均值(± 标准差)为 46.6 ± 21.0 单位。出生体重的平均值(± SD)为 3367.0 ± 861.3 克。在妊娠 28 周、32 周或 36 周时,TIR 与胎儿 AC 之间没有横截面关系。回归分析的结果表明,在控制产妇年龄、体重指数、泵的使用和TDD胰岛素的情况下,妊娠32周和36周时的首胎TIR(独立预测因子)与胎儿AC(因变量)之间存在显著关系(32周和36周时的Adjβ=-0.42,95%CI为-0.80至-0.03;32周和36周时的Adjβ=-0.57,95%CI为-1.02至-0.12)。虽然妊娠头三个月的 HbA1c 与妊娠 32 周时的胎儿 AC 之间存在显著关系(β = 3.81,95%CI 0.29 至 7.33),但在调整了混杂因素后,两者之间的关系并不显著:结论:在妊娠三个月中,TIR 与胎儿 AC 之间没有横断面关系,但在妊娠晚期,妊娠头三个月的 TIR 确实可以预测胎儿 AC。
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来源期刊
CiteScore
4.40
自引率
0.00%
发文量
217
审稿时长
2-3 weeks
期刊介绍: The official journal of The European Association of Perinatal Medicine, The Federation of Asia and Oceania Perinatal Societies and The International Society of Perinatal Obstetricians. The journal publishes a wide range of peer-reviewed research on the obstetric, medical, genetic, mental health and surgical complications of pregnancy and their effects on the mother, fetus and neonate. Research on audit, evaluation and clinical care in maternal-fetal and perinatal medicine is also featured.
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