Original researchGestational diabetes mellitus and lesser degrees of pregnancy hyperglycemia: association with increased risk of spontaneous preterm birth☆
Section snippets
Materials and methods
The setting of the study was the Kaiser Permanente Medical Care Program of Northern California, a large group-practice prepaid health plan that has approximately 2.7 million members in a 14-county region in Northern California. The Kaiser Permanente Medical Care Program of Northern California membership represents approximately 30% of the surrounding population and is representative of the population living in the same geographic area demographically, ethnically, and socioeconomically, except
Results
Among the 46,230 pregnancies that underwent a 50-g, 1-hour oral glucose tolerance test at 24–28 weeks and resulted in deliveries at the Kaiser Permanente Medical Care Program of Northern California between January 1996 and June 1998, the mean age of the women was 28.7 years (standard deviation [SD] 5.9). The race–ethnicity distribution was 50.8% white, 16.6% Asian, 20.0% Hispanic, 7.4% black, and 5.3% other or unknown. Among these pregnancies, 1956 (4.2%) spontaneous preterm births occurred.
Discussion
We found that GDM and lesser degrees of maternal hyperglycemia (such as abnormal screening or the lower Carpenter–Coustan plasma glucose thresholds in pregnancies without GDM) were associated with an increased risk of spontaneous preterm birth. These associations were also independent of conditions such as preeclampsia–eclampsia and birth weight for gestational age, which may have triggered an earlier delivery.
Our results are consistent with the results of a study5 including a small number (n =
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2023, The Lancet Regional Health - Western Pacific
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Supported by a grant (R01 DK 54834) from the National Institute of Diabetes and Digestive and Kidney Diseases, a Research Award from the American Diabetes Association, and a research award from Kaiser Foundation Research Institute given to AF.
Two abstracts on portions of these data were published in the abstract book of the 59th Annual Scientific Sessions of the American Diabetes Association (Diabetes 2002;51 Suppl 2) and in the abstract book of the 2001 Congress of Epidemiology (Am J Epidemiol 2001;153 Suppl).