Fetal malformations in women with pregestational diabetes mellitus based on pre-pregnancy fasting plasma glucose levels

To evaluate the risk of fetal malformation in pregnant women with pregestational diabetes mellitus based on pre-pregnancy fasting plasma glucose (FPG) levels. This cohort study used the Korean Health Insurance Review and Assessment (HIRA) database, including 5,687 women with pre-pregnancy diabetes and FPG measurements within one year before conception. Subjects were grouped into three glycemic level categories: low (FPG < 100 mg/dL [< 5.5 mmol/L]), moderate (FPG: 100-125 mg/dL [5.6-6.9 mmol/L]), and high (FPG ≥ 126 mg/dL [≥ 7.0 mmol/L]). The low glycemic group was divided into four subgroups based on FPG levels. The relative risks of fetal malformations were calculated using multivariable analysis compared to a reference group (FPG < 84 mg/dL [< 4.7 mmol/L]). Fetal malformation rates were 10% in the low, 13.6% in the moderate, and 18.6% in the high glycemic groups (P < 0.001). Teratogenic risks were 1.3 times higher in the moderate glycemic group and 1.8 times higher in the high glycemic group compared to the reference group. The high glycemic group had 2.5 times greater risk of cardiac malformations and 3.3 times greater risk of skeletal malformations. Preconceptional FPG levels ≥ 100 mg/dL [≥ 5.5 mmol/L] in women with pregestational diabetes elevate the risk of fetal malformations, especially cardiac and skeletal malformations at FPG levels ≥ 126 mg/dL [≥ 7.0 mmol/L].

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Publication Details

Journal
Scientific Reports
Published
2025-11-20
DOI
https://doi.org/10.1038/s41598-025-24954-0
Primary Topic
Gestational Diabetes Research and Management
Type
article
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article

Fetal malformations in women with pregestational diabetes mellitus based on pre-pregnancy fasting plasma glucose levels

Hyun‐Ghang Jeong, Young Mi Jung, Hyun Sun Ko, Hyun Soo Park et al.
Scientific Reports
Gestational Diabetes Research and Management
article

Fetal malformations in women with pregestational diabetes mellitus based on pre-pregnancy fasting plasma glucose levels

Hyun‐Ghang Jeong, Young Mi Jung, Hyun Sun Ko, Hyun Soo Park, Won Joon Seong, Ji Young Kwon, Geum Joon Cho, Sae-Kyoung Choi, Subeen Hong, Seungchul Kim, Hyun‐Joo Seol, Ji‐Hee Sung, Joon Ho Lee, Kyung A. Lee, Soo Ran Choi
article en

Abstract

To evaluate the risk of fetal malformation in pregnant women with pregestational diabetes mellitus based on pre-pregnancy fasting plasma glucose (FPG) levels. This cohort study used the Korean Health Insurance Review and Assessment (HIRA) database, including 5,687 women with pre-pregnancy diabetes and FPG measurements within one year before conception. Subjects were grouped into three glycemic level categories: low (FPG < 100 mg/dL [< 5.5 mmol/L]), moderate (FPG: 100-125 mg/dL [5.6-6.9 mmol/L]), and high (FPG ≥ 126 mg/dL [≥ 7.0 mmol/L]). The low glycemic group was divided into four subgroups based on FPG levels. The relative risks of fetal malformations were calculated using multivariable analysis compared to a reference group (FPG < 84 mg/dL [< 4.7 mmol/L]). Fetal malformation rates were 10% in the low, 13.6% in the moderate, and 18.6% in the high glycemic groups (P < 0.001). Teratogenic risks were 1.3 times higher in the moderate glycemic group and 1.8 times higher in the high glycemic group compared to the reference group. The high glycemic group had 2.5 times greater risk of cardiac malformations and 3.3 times greater risk of skeletal malformations. Preconceptional FPG levels ≥ 100 mg/dL [≥ 5.5 mmol/L] in women with pregestational diabetes elevate the risk of fetal malformations, especially cardiac and skeletal malformations at FPG levels ≥ 126 mg/dL [≥ 7.0 mmol/L].

Scientific ReportsVol. 15(1)
Ewha Womans University (KR), Inha University (KR), Korea University (KR), Dongguk University (KR), University Health System (US), Samsung Medical Center (KR), Seoul National University Bundang Hospital (KR), Kyungpook National University (KR), St. Joseph Hospital (US), St. Mary's Hospital (US), The Catholic University of Korea Incheon St. Mary's Hospital (KR), Pusan National University Hospital (KR), St Mary's Hospital (GB), The Catholic University of Korea Seoul St. Mary's Hospital (KR), Yonsei University Health System (KR), Korea University (JP), Pusan National University (KR), Sungkyunkwan University (KR), Catholic University of Korea (KR)
Openalex Percentile: Top 55%
Gestational Diabetes Research and Management
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