Pre-pregnancy maternal fasting plasma glucose levels in relation to time to pregnancy among the couples attempting first pregnancy
Permanent link to this recordhttp://hdl.handle.net/20.500.12613/4585
MetadataShow full item record
Abstract© 2019 The Author(s). STUDY QUESTION: What is the relationship between pre-pregnancy maternal glucose levels and fecundability in Chinese couples? SUMMARY ANSWER: Elevated pre-pregnancy maternal glucose levels were associated with fecundability, as reflected by prolonged time to pregnancy (TTP) among the couples with no prior gravidity. STUDY DESIGN, SIZE, DURATION: Based on the National Free Pre-conception Check-up Projects supported by the Chinese government, 2 226 048 eligible couples attempting first pregnancy and participating in the project from 2015 to 2016 were included. They were followed-up for 1 year or until they reported pregnancy. PARTICIPANTS/MATERIALS, SETTINGS, METHODS: The Kaplan-Meier method was used to estimate the cumulative pregnancy rate in each menstrual cycle, and the discrete-time analogue of the Cox models was used to estimate the fecundability odds ratios (FORs) and 95% CIs by different pre-pregnancy maternal glucose levels (impaired fasting glucose (IFG) or diabetes as compared to normal). MAIN RESULTS AND THE ROLE OF CHANCE: The cumulative pregnancy rate for 12 cycles of the normal fasting plasma glucose (FPG) level group was 42.29%, significantly higher than that of the IFG (35.52%) and diabetes groups (31.52%). After adjusting for confounding factors, the FORs were 0.82 (95% CI: 0.81-0.83) and 0.74 (95% CI: 0.72-0.76) for the IFG and diabetes groups, respectively, as compared to the normal group. The association between pre-pregnancy maternal FPG levels and the FORs was non-linear, and the optimal FPG level for greatest fecundability (shortest TTP) was 3.90-4.89 mmol/L. LIMITATIONS, REASONS FOR CAUTION: The findings from this register-based cohort study require cautious interpretation given that information bias would be inevitable for single FPG measurements and for TTP calculations that were based on telephone follow-up information. Additionally, because couples who achieved pregnancy during their first menstrual cycle in the study were excluded, the pregnancy rates reported were low and possibly biased. WIDER IMPLICATIONS OF THE FINDINGS: The current report suggests that elevated pre-pregnancy maternal glucose levels were associated with prolonged TTP. Early evaluation and preventive treatment for female partners with IFG or diabetes in a pre-pregnancy examination are necessary. STUDY FUNDING/COMPETING INTEREST(S): Funding was provided by the National Key Research and Development Program of China (grants No. 2016YFC1000300 and 2016YFC1000307), the National Natural Science Foundation of China (grant No. 81872634), the CAMS Innovation Fund for Medical Sciences (grant No. 2018-I2M-1-004), the National Human Genetic Resources Sharing Service Platform (grant No. 2005DKA21300) and the National Population and Reproductive Health Science Data Center (grant No. 2005DKA32408), People's Republic of China. The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER: N/A
Citation to related workOxford University Press (OUP)
Has partHuman Reproduction
ADA complianceFor Americans with Disabilities Act (ADA) accommodation, including help with reading this content, please contact email@example.com
Showing items related by title, author, creator and subject.
The role of chlamydia trachomatis polymorphic membrane proteins in inflammation and sequelae among women with pelvic inflammatory diseaseTaylor, BD; Darville, T; Tan, C; Bavoil, PM; Ness, RB; Haggerty, CL; Taylor, Brandie|0000-0002-8234-1815 (2011-12-01)Chlamydia trachomatis polymorphic membrane proteins (Pmps) may increase genital tract inflammation and play a role in virulence. Antibody levels for PmpA, PmpD, and PmpI, measured in densitometric units, were assessed among a pilot sample of 40 C. trachomatis-infected women with mild-to-moderate clinical PID. Women who expressed antibodies to PmpA were less likely to achieve pregnancy (40.0 versus 85.7; P = 0.042) and less likely to have a live birth (0.0 versus 80.0; P = 0.005) compared to women who did not express antibody to PmpA. Women who expressed antibodies to PmpI were more likely to have upper genital tract infection (61.5 versus 20.0; P = 0.026). However, seropositivity to PmpI and PmpD did not modify the risk of reproductive sequelae or inflammation. Seropositivity to chlamydial PmpA may represent a biomarker of increased risk of sequelae secondary to infection with C. trachomatis. © 2011 Brandie D. Taylor et al.
Maternal behaviors during pregnancy impact offspring obesity riskPhelan, S; Hart, C; Phipps, M; Abrams, B; Schaffner, A; Adams, A; Wing, R (2011-12-01)This study investigated the effects of maternal changes during pregnancy in diet, exercise, and psychosocial factors on offspring weight parameters at birth and 6 months. In overweight/obese (OW/OB; n = 132) mothers, greater % kcal from sweets early in pregnancy was the strongest, independent predictor of higher weight for age (WFA) (beta = 0. 19; P = 0. 004), higher odds of macrosomia (OR = 1.1 (1.01.2); P = 0. 004) andWFA 90th percentile at birth (OR = 1.2 (1.11.3); P = 0. 002) and higher WFA at 6 months (beta = 0. 30; P = 0. 002). In normal weight (n = 153) mothers, higher intake of soft drinks was the strongest predictor of higher offspring WFA at birth (beta = 0.16; P = 0. 04) but not at 6 months. Prenatal physical activity, depressive symptoms, and sleep-related variables did not significantly predict offspring weight outcomes. Mothers eating behaviors during pregnancy, especially intake of sweets in OW/OB mothers, may have a lasting effect on child weight. Copyright © 2011 Suzanne Phelan et al.
One-year postpartum anthropometric outcomes in mothers and children in the LIFE-Moms lifestyle intervention clinical trialsPhelan, Suzanne; Clifton, Rebecca G; Haire-Joshu, Debra; Redman, Leanne M; Van Horn, Linda; Evans, Mary; Joshipura, Kaumudi; Couch, Kimberly A; Arteaga, S Sonia; Cahill, Alison G; Drews, Kimberly L; Franks, Paul W; Gallagher, Dympna; Josefson, Jami L; Klein, Samuel; Knowler, William C; Martin, Corby K; Peaceman, Alan M; Thom, Elizabeth A; Wing, Rena R; Yanovski, Susan Z; Pi-Sunyer, Xavier; Phelan, S; Wing, RR; Hagobian, TA; Schaffner, A; Hart, C; Yin, EK; Phipps, MG; Abrams, B; Scholl, TO; Savitz, DA; Gallagher, D; Pi-Sunyer, X; Thornton, J; Rosenn, B; Paley, C; Gidwani, S; Horowitz, M; Joshipura, K; Franks, PW; Palacios, C; Campos, M; Rivera, J; Willett, WC; Zorrilla, C; Soltero, S; Hu, F; Cordero, J; Trak, MA; Melendez, M; Cahill, AG; Klein, S; Haire-Joshu, D; Stein, R; Mathur, A; Cade, WT; Moley, K; Peaceman, AM; Van Horn, L; Kwasny, M; Josefson, JL; Neff, L; Spring, B; Redman, LM; Martin, CK; Elkind-Hirsh, K; Breaux, J; Johnson, W; Frost, EA; Knowler, WC; Couch, KA; Curtis, JM; Dunnigan, DL; Hanson, RL; Hoskin, M; Kavena, K; Kishi, GY; Moffett, C; Murphy, S; Nelson, RG; Pomeroy, J; Shovestull, L; Williams, Rachel; Clifton, RG; Thom, EA; Drews, K; Boekhoudt, T; Evans, M; Yanovski, SZ; Arteaga, S; Alekel, DL; Grp, LIFE-Moms Res (2020-01)BACKGROUND/OBJECTIVES: Excess gestational weight gain (GWG) is a risk factor for maternal postpartum weight retention and excessive neonatal adiposity, especially in women with overweight or obesity. Whether lifestyle interventions to reduce excess GWG also reduce 12-month maternal postpartum weight retention and infant weight-for-length z score is unknown. Randomized controlled trials from the LIFE-Moms consortium investigated lifestyle interventions that began in pregnancy and tested whether there was benefit through 12 months on maternal postpartum weight retention (i.e., the difference in weight from early pregnancy to 12 months) and infant-weight-for-length z scores. SUBJECTS/METHODS: In LIFE-Moms, women (N = 1150; 14.1 weeks gestation at enrollment) with overweight or obesity were randomized within each of seven trials to lifestyle intervention or standard care. Individual participant data were combined and analyzed using generalized linear mixed models with trial entered as a random effect. The 12-month assessment was completed by 83% (959/1150) of women and 84% (961/1150) of infants. RESULTS: Compared with standard care, lifestyle intervention reduced postpartum weight retention (2.2 ± 7.0 vs. 0.7 ± 6.2 kg, respectively; difference of -1.6 kg (95% CI -2.5, -0.7; p = 0.0003); the intervention effect was mediated by reduction in excess GWG, which explained 22% of the effect on postpartum weight retention. Lifestyle intervention also significantly increased the odds (OR = 1.68 (95% CI, 1.26, 2.24)) and percentage of mothers (48.2% vs. 36.2%) at or below baseline weight at 12 months postpartum (yes/no) compared with standard care. There was no statistically significant treatment group effect on infant anthropometric outcomes at 12 months. CONCLUSIONS: Compared with standard care, lifestyle interventions initiated in pregnancy and focused on healthy eating, increased physical activity, and other behavioral strategies resulted in significantly less weight retention but similar infant anthropometric outcomes at 12 months postpartum in a large, diverse US population of women with overweight and obesity.