Correlation of Continuous Glucose Monitoring Profiles with Pregnancy Outcomes in Nondiabetic Women

ObjectiveTo determine whether hyperglycemic excursions detected by continuous glucose monitoring (CGM) correlate with birth weight percentile and other pregnancy outcomes, and whether CGM correlates better with these outcomes than a single glucose value from a 1-hour glucose challenge test (GCT). Study DesignThis was a prospective observational study of 55 pregnant patients without preexisting diabetes, who wore a CGM device for up to 7 days, between 24 and 28 weeks' gestation. The area under the curve (AUC) of hyperglycemic excursions above various thresholds (110, 120, 130, 140, and 180 mg/dL) was calculated. These AUC values, and results from a standard 50-g GCT, were correlated with our primary outcome of birth weight percentile, and secondary outcomes of unplanned operative delivery, pregnancy complications, delivery complications, fetal complications, and neonatal complications. ResultsA consistent correlation was seen between all AUC thresholds and birth weight percentile (r=0.29, p<0.05 for AUC-110, -120, -130, and -140; r=0.25, p=0.07 for AUC-180). This correlation was stronger than that of 1-hour oral GCT (r=-0.02, p=0.88). There was no association between AUC values and other outcomes. ConclusionsAmong nondiabetic pregnant patients, hyperglycemic excursions detected by CGM show a stronger correlation to birth weight percentile than blood glucose values obtained 1-hour after a 50-g oral GCT.