A recent study indicates that having prediabetes before pregnancy can significantly raise the chances of developing gestational diabetes during a woman’s first pregnancy.
Researchers at Mount Sinai have conducted a study revealing a connection between prediabetes in younger individuals and negative pregnancy outcomes later on. Their findings, which appeared in JAMA Network Open on September 24, may lead to changes in how healthcare providers regularly check and advise youth about their blood sugar levels, aiming to reduce potential risks for both mothers and newborns.
Prediabetes is a critical health issue characterized by blood sugar levels that are above normal but not high enough to be classified as type 2 diabetes. This condition can elevate the risk of heart disease and stroke, and it disproportionately affects Hispanic and Black populations, as well as those with lower income. A report from JAMA Pediatrics indicates that the prevalence of prediabetes among U.S. youth has surged over the past ten years, now affecting nearly one in three individuals aged 12 to 19.
In this new research, Mount Sinai scientists investigated the implications of prediabetes prior to conception among adolescents and young adults, as this demographic is particularly vulnerable to unplanned pregnancies and is less likely to receive beneficial preconception health advice.
The study involved a retrospective cohort analysis of more than 14,000 individuals aged 10 to 24, utilizing data from New York City’s birth registry, hospital discharge records, and A1C Registry data collected between 2009 and 2017. Participants had no diabetes history and at least one hemoglobin A1c (HbA1c) test result before their first childbirth. The findings indicated that prediabetes before conception was linked to a more than twofold increase in the risk of gestational diabetes in subsequent pregnancies. Additionally, the study noted an 18 percent higher risk for pregnancy-related hypertension disorders, including gestational hypertension and preeclampsia, and the possibility of premature delivery, associated with prediabetes during youth.
The researchers also examined which levels of hemoglobin A1c—an indicator of average blood sugar levels over the past three months—were most closely associated with gestational diabetes for those under 24. They found that the optimal threshold for young people is slightly lower than that for adults (5.6 percent compared to 5.7 percent). The overall results indicate a pressing need for clear clinical guidelines on how to screen and provide counsel to young individuals with elevated blood sugar levels but no other risk factors, the researchers emphasized.
“The absence of standardized treatment guidelines for adolescent preconception prediabetes may lead to lost chances to prevent complications during pregnancy,” stated the study’s lead author, Katharine McCarthy, PhD, MPH, Assistant Professor of Population Health Science and Policy, and Obstetrics, Gynecology, and Reproductive Science at the Icahn School of Medicine at Mount Sinai. “Our findings advocate for increased screening of hemoglobin A1c before conception to address excess cardiometabolic risks at an earlier stage of life.”
Moving forward, the researchers plan to explore school policies and interventions aimed at decreasing the risk of heart and metabolic health issues during adolescence, potentially improving pregnancy and overall health outcomes throughout life.
This study also included contributions from researchers at the Columbia University Mailman School of Public Health, the NYC Department of Health and Mental Hygiene, and the Department of Maternal and Fetal Medicine at Stamford Hospital. It received funding from the National Institutes of Health under several grant numbers (R01DK134725, R21DK122266, and UL1TR004419).
