ESPE Yearbook of Paediatric Endocrinology

To read the full abstract: PLoS Med. 2019 Oct 1;16(10):e1002926. doi: 10.1371/journal.pmed.1002926.

The authors analysed a huge dataset from the Chinese national programme of preconception health checks, which include measurements of fasting plasma glucose. Overall, 13.15% (n =847,737) had impaired fasting glucose and 1.18% (n =76,297 women) had diabetes, of whom only 1.2% (917 women) were previously aware of having diabetes.

Women with diabetes or impaired fasting glucose had significantly higher risks of spontaneous abortion (Odds ratios: 1.11 and 1.08, respectively), pre-term birth (1.17 and 1.02), macrosomia (1.13 and 1.07), SGA (1.17 and 1.06), and perinatal infant death (1.59 and 1.08).

Despite much research focus on the prevention of gestational diabetes, there are as yet few effective interventions (1). Therefore, attention in this field is shifting to possible windows for intervention in early gestation or even before pregnancy. This study indicates that there is certainly much potential benefit for pregnancy outcomes and offspring health of correcting high glucose levels in the preconception period. A first step is to highlight the opportunity for pre-pregnancy health screening. In this regard, the Chinese National Free Pre-Pregnancy Checkups Project described here is greatly informative in identifying during preconception many women who were unaware of their diabetes status, and many more with ‘pre-diabetes’. This may be a valuable model for other countries to follow.

Reference:

1. H Al Wattar B, et al., Mediterranean-style diet in pregnant women with metabolic risk factors (ESTEEM): A pragmatic multicentre randomised trial. PLoS Med. 2019 Jul 23;16(7):e1002857. doi: 10.1371/journal.pmed.1002857.