The association between pre-pregnancy impaired fasting glucose and adverse perinatal outcome

Aims: To evaluate the association between impaired fasting glucose (IFG) prior to pregnancy with maternal and neonatal outcome. Methods: A retrospective cohort study of singleton deliveries in a single, tertiary, university-affiliated medical center between August 2007 and December 2012. We included women who had a fasting glucose test done up to 26 weeks prior to pregnancy. We excluded women with diabetes mellitus and women carrying a fetus with structural or chromosomal anomalies. Maternal and neonatal outcome were compared between two groups: women with pre-pregnancy IFG (defined as fasting glucose >= 100 mg/dl and < 126 mg/dl) versus those with normoglycemia (fasting glucose < 100 mg/dl). Results: Overall, 1945 women met inclusion criteria. Of whom, 1790 had pre-pregnancy glucose < 100 mg/dl and 155 had IFG. There were no differences between groups in basic characteristics. As for maternal outcome, IFG was associated with higher rates of mild preeclampsia (5.16% vs 0.67%), abnormal glucose challenge test (21.94% vs 13.46%) and gestational diabetes (13.55 vs 2.85%), p < 0.05 for all. There were no significant differences in neonatal outcome. After adjusting for potential confounders, on multivariable logistic regression, pre-pregnancy IFG remained significantly and independently associated with mild preeclampsia (aOR 6.92, 95% CI 2.68-18.05, p < 0.001). Conclusions: Pre-pregnancy IFG is associated with increased risk for abnormal glucose challenge test and gestational diabetes, and it is an independent risk factor for adverse pregnancy outcome including mild preeclampsia. (C) 2018 Elsevier B.V. All rights reserved.