O9 Maternal glycemia of 1st Trimester of pregnancy Maternal glycemia of 1st Trimester of pregnancy and itsassociationwiththedevelopment of DG. Categorizationaccording to pregestational BMI

Abstract

Objectives: primary: determine the probability of developing GD according to the fasting blood glucose values ​​of the first trimester of pregnancy (GA1ERT >85 mg/dl) according to BMI category, age and maternal weight gain. Secondary: compare maternal triglyceridemia of the last trimester, fetal weight and fasting glycemia of OGTT according to BMI categories in patients with and without a diagnosis of GD. Determine the prevalence of macrosomia in the different group categories.

Materials and methods: A total of 420 records were evaluated. The inclusion criteria for both groups were: age over 18 years, complete HC records, diagnosis of GD by OGTT. 296 HCs met these criteria. 127 HC corresponded to patients with a diagnosis of GD and 169 HC corresponded to patients without GD. These groups were categorized according to their pregestational BMI into three groups: BMI <25 (Group A), BMI 25-30 (Group B) and patients with BMI >30 (Group C). These categories were matched according to age and maternal weight gain throughout pregnancy in order to avoid bias between groups. The variables analyzed were: age, pregestational BMI, maternal weight gain, OGTT results (according to SAD-ALAD criteria), maternal triglyceridemia in the last trimester (TAG); these were evaluated as continuous variables. The variables GA1ERT >85 mg/dl and fetal macrosomia were evaluated as dichotomous variables. The Kolmogorov-Smirnov normality test was performed. Continuous variables with a normal distribution are presented as means and standard deviation, and variables with a non-normal distribution are presented as medians and interquartile range. To determine the probability of risk for the development of GD according to GA1ERT >85 mg/dl, OR and its magnitude (ME) were calculated as insignificant; if it is between 1.68-3.47, small; between 3.47-6.71, moderate; and if it is greater than 6.71, large. The prevalence of macrosomia was calculated for each category of both groups. The data were loaded into Excel spreadsheets and analyzed in SPSS v22.

Results: the OR of DG for category A was 15 times, for category B it was 9.2 times and for category C 10.7 times with a large effect size for all three categories. There were no differences between fetal weight (p=0.14, 0.36 and 0.59 respectively). The GA of OGTT was significant in all categories (p=0.002, 0.01 and <0.001 respectively), the maternal TG of the last trimester were significant in categories A and B (p=0.04 and 0.026 respectively). The prevalence of macrosomia increased in relation to the increase in BMI.

Conclusions: the magnitude of the effect of fasting blood glucose in the first trimester greater than 85 mg/dl is in the “large” category for all BMI groups, suggesting that it is a strong predictor of GD, especially in patients with normal BMI. The OGTT GA increases as the BMI category increases, this being the main criterion for the diagnosis of GD in a patient with a BMI >30 (2 fasting blood glucose levels greater than or equal to 100 mg/dl). In the fetal weight variable, an increasing trend was observed in the measure that increases BMI for all groups. The maternal TG variable showed an exponential increase with the increase in BMI category, this being statistically significant. An increase in the prevalence of fetal macrosomia was observed in direct proportion to the BMI category in both groups, its prevalence being higher for the group with GD compared to the group without GD.