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Gestational Diabetes Risk Higher in Women With Preconception Prediabetes

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Increased likelihood of a hypertensive disorder of pregnancy and preterm delivery also seen

By Elana Gotkine HealthDay Reporter

TUESDAY, Oct. 1, 2024 (HealthDay News) — Preconception prediabetes is associated with increased odds of gestational diabetes among adolescents and young adults, according to a study published online Sept. 24 in JAMA Network Open.

Katharine J. McCarthy, Ph.D., from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues conducted a retrospective cohort study using linked 2009 to 2017 birth registry, hospital discharge, and New York City Department of Health A1C Registry data for pregnant individuals aged 10 to 24 years. Eligibility criteria were met by 14,302 individuals: 41.0 percent Hispanic, 29.0 percent Black, 18.1 percent White, 10.6 percent Asian, and 1.3 percent other or unknown race and ethnicity.

The researchers found that 79.7 and 20.2 percent of participants had normoglycemia and prediabetes, respectively. Compared with those with normoglycemia, those with preconception prediabetes had more than twice the risk for gestational diabetes (adjusted relative risk [aRR], 2.21) after adjusting for prepregnancy characteristics. Small increases in the likelihood of a hypertensive disorder of pregnancy (aRR, 1.18) and preterm delivery (aRR, 1.18) were seen in association with preconception prediabetes. Increases were seen in the risks for cesarean delivery and macrosomia, but they were not statistically significant. For identifying gestational diabetes among adolescents and young adults, the optimal hemoglobin A1c threshold was 5.6 percent.

“Given alarming trends in adolescent obesity and diabetes risk and the high prevalence of unplanned pregnancies in adolescence and young adulthood, our results support expanded preconception screening as a mechanism to intervene on excess cardiometabolic risk earlier in the life course,” the authors write.

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