Evidence mapPaperPMID 40097016Full record

ArticleAmerican journal of obstetrics & gynecology MFM2025

Glucose time in range trajectories during pregnancy and association with adverse perinatal outcomes: a joint latent-class trajectory modeling approach.

Sara M Sauer, Isabel Fulcher, Ayodeji Sanusi, Ashley N Battarbee

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Article in American journal of obstetrics & gynecology MFM, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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field-weighted citation impact
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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Sara M SauerDelfina Care, San Francisco, CA (Sauer and Fulcher); Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA (Sauer). Electronic address: sara@delfina.com.
Isabel FulcherDelfina Care, San Francisco, CA (Sauer and Fulcher).
Ayodeji SanusiCenter for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL (Sanusi and Battarbee); Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Alabama at Birmingham, Birmingham, AL (Sanusi and Battarbee).
Ashley N BattarbeeCenter for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL (Sanusi and Battarbee); Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Alabama at Birmingham, Birmingham, AL (Sanusi and Battarbee).

Funding

PROGRAM FOR AIDS CLINICAL RESEARCH TRAINING (PACRT)T32AI007433 · MASSACHUSETTS GENERAL HOSPITAL · 1992 to 2025
$2.0M
UAB Diabetes Research CenterP30DK079626 · UNIVERSITY OF ALABAMA AT BIRMINGHAM · 2025 to 2025
$1.3M
Close the GAP: Glycemic control after Antenatal corticosteroids in women with Pregestational diabetesK23HD103875 · NICHD · UNIVERSITY OF ALABAMA AT BIRMINGHAM · 2022 to 2025
$661k
NIAID NIH HHS T32 AI007433NICHD NIH HHS K23 HD103875NIDDK NIH HHS P30 DK079626
6 · The paper itself

Abstract

backgroundWhile time in range (TIR) summarized over pregnancy is associated with adverse outcomes among individuals with preexisting type 1 or 2 diabetes, the impact of TIR trajectories with advancing gestation is unknown.

objectiveTo identify glucose TIR trajectories across pregnancy and evaluate their association with perinatal outcomes among patients with preexisting diabetes. STUDY

designRetrospective, single-center cohort study of pregnant patients with type 1 or 2 diabetes who used continuous glucose monitoring (CGM) and delivered in 2019 to 2023. Weekly TIR (65-140 mg/dL) was computed starting at 10 weeks' gestation, and joint latent-class trajectory modeling identified discrete TIR trajectory groups. Patients were classified into groups, and multivariable logistic regression estimated the associations between groups and perinatal outcomes.

resultsOf 179 pregnant patients, 91 had type 1 and 88 had type 2 diabetes. We identified four TIR trajectory groups using data from over 5.1 million CGM measurements: (1) good control, stable (n=48), (2) moderate control, initial improvement, and late decline (n=22), (3) moderate control, late improvement (n=63), and (4) poor control, initial worsening and late improvement (n=46). All perinatal outcomes differed by TIR trajectory. Groups 2, 3, and 4 with suboptimal control in early pregnancy were associated with higher odds of preterm birth, indicated preterm birth, and NICU admission, compared to group 1. Groups 3 and 4, which had the lowest TIR during second and early third trimesters, were associated with higher odds of large-for-gestational-age (LGA). Only group 4 was associated with higher odds of preeclampsia and neonatal hypoglycemia.

conclusionAchieving glycemic control in the second and early third trimesters during fetal and placental growth and development is important to reduce the risk of adverse pregnancy outcomes, particularly LGA. Third-trimester TIR decline may impact risk of preterm birth and NICU admission.

Indexed as

Blood GlucoseDiabetes Mellitus, Type 1Diabetes Mellitus, Type 2Pregnancy in DiabeticsAdultBlood Glucose Self-MonitoringFemaleHumansInfant, NewbornLatent Class AnalysisPregnancyPregnancy OutcomePremature BirthRetrospective StudiesTime FactorsBlood Glucose

Identifiers

PMID40097016
PMCPMC12129658

What Socratic holds

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LicenceTDM
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.