Abstract：
BACKGROUND: The implication of intermediately elevated fasting plasma glucose (FPG) in the first trimester of pregnancy is uncertain.
OBJECTIVE: The primary outcome of the meta-analysis was to analyze if intermediately elevated first-trimester FPG could predict development of GDM at 24-28 weeks. The secondary outcomes were to determine if the commonly used FPG cut-offs 5.1 mmol/L (92 mg/dL), 5.6 mmol/L (100 mg/dL), and 6.1 mmol/L (110 mg/dL) correlated with adverse pregnancy events.
METHODS: Databases were searched for articles published from 2010 onwards for studies examining the relationship between first-trimester FPG and adverse fetomaternal outcomes.
METHODS: A total of sixteen studies involving 115,899 pregnancies satisfied the inclusion criteria.
METHODS: Women who developed GDM had a significantly higher first-trimester FPG than those who did not [MD 0.29 mmoL/l (5 mg/dL); 95 % CI: 0.21-0.38; P < 0.00001]. First-trimester FPG ≥5.1 mmol/L (92 mg/dL) predicted the development of GDM at 24-28 weeks [RR 3.93 (95 % CI: 2.67-5.77); P < 0.0000], pre-eclampsia [RR 1.55 (95%CI:1.14-2.12); P = 0.006], gestational hypertension [RR1.47 (95%CI:1.20-1.79); P = 0.0001], large-for-gestational-age (LGA) [RR 1.32 (95%CI:1.13-1.54); P = 0.0004], and macrosomia [RR1.29 (95%CI:1.15-1.44); P < 0.001]. However, at the above threshold, the rates of preterm delivery, lower-segment cesarean section (LSCS), small-for gestational age (SGA), and neonatal hypoglycemia were not significantly higher. First-trimester FPG ≥5.6 mmol/L (100 mg/dL) correlated with occurrence of macrosomia [RR1.47 (95 % CI:1.22-1.79); P < 0.0001], LGA [RR 1.43 (95%CI:1.24-1.65); P < 0.00001], and preterm delivery [RR1.51 (95%CI:1.15-1.98); P = 0.003], but not SGA and LSCS.
CONCLUSIONS: Only one study reported outcomes at first-trimester FPG of 6.1 mmol/L (110 mg/dL), and hence was not analyzed.
CONCLUSIONS: The risk of development of GDM at 24-28 weeks increased linearly with higher first-trimester FPG. First trimester FPG cut-offs of 5.1 mmol/L (92 mg/dL) and 5.6 mmol/L (100 mg/dL) predicted several adverse pregnancy outcomes.
OBJECTIVE: The primary outcome of the meta-analysis was to analyze if intermediately elevated first-trimester FPG could predict development of GDM at 24-28 weeks. The secondary outcomes were to determine if the commonly used FPG cut-offs 5.1 mmol/L (92 mg/dL), 5.6 mmol/L (100 mg/dL), and 6.1 mmol/L (110 mg/dL) correlated with adverse pregnancy events.
METHODS: Databases were searched for articles published from 2010 onwards for studies examining the relationship between first-trimester FPG and adverse fetomaternal outcomes.
METHODS: A total of sixteen studies involving 115,899 pregnancies satisfied the inclusion criteria.
METHODS: Women who developed GDM had a significantly higher first-trimester FPG than those who did not [MD 0.29 mmoL/l (5 mg/dL); 95 % CI: 0.21-0.38; P < 0.00001]. First-trimester FPG ≥5.1 mmol/L (92 mg/dL) predicted the development of GDM at 24-28 weeks [RR 3.93 (95 % CI: 2.67-5.77); P < 0.0000], pre-eclampsia [RR 1.55 (95%CI:1.14-2.12); P = 0.006], gestational hypertension [RR1.47 (95%CI:1.20-1.79); P = 0.0001], large-for-gestational-age (LGA) [RR 1.32 (95%CI:1.13-1.54); P = 0.0004], and macrosomia [RR1.29 (95%CI:1.15-1.44); P < 0.001]. However, at the above threshold, the rates of preterm delivery, lower-segment cesarean section (LSCS), small-for gestational age (SGA), and neonatal hypoglycemia were not significantly higher. First-trimester FPG ≥5.6 mmol/L (100 mg/dL) correlated with occurrence of macrosomia [RR1.47 (95 % CI:1.22-1.79); P < 0.0001], LGA [RR 1.43 (95%CI:1.24-1.65); P < 0.00001], and preterm delivery [RR1.51 (95%CI:1.15-1.98); P = 0.003], but not SGA and LSCS.
CONCLUSIONS: Only one study reported outcomes at first-trimester FPG of 6.1 mmol/L (110 mg/dL), and hence was not analyzed.
CONCLUSIONS: The risk of development of GDM at 24-28 weeks increased linearly with higher first-trimester FPG. First trimester FPG cut-offs of 5.1 mmol/L (92 mg/dL) and 5.6 mmol/L (100 mg/dL) predicted several adverse pregnancy outcomes.
摘要：
背景：妊娠早期空腹血糖（FPG）升高的意义尚不确定。
目的：荟萃分析的主要结果是分析妊娠早期FPG升高是否可以预测24-28周时GDM的发展。次要结果是确定常用的FPG截止值5.1mmol/L（92mg/dL），5.6mmol/L（100mg/dL），6.1mmol/L（110mg/dL）与不良妊娠事件相关。
方法：在数据库中搜索了从2010年开始发表的文章，以研究孕早期FPG与胎儿不良结局之间的关系。
方法：共有16项研究，涉及115,899例妊娠，符合纳入标准。
方法：患GDM的妇女早孕FPG明显高于未患GDM的妇女[MD0.29mmoL/l(5mg/dL);95%CI:0.21-0.38;P<0.00001]。孕早期FPG≥5.1mmol/L(92mg/dL)预测24-28周时GDM的发展[RR3.93(95%CI:2.67-5.77);P<0.0000],先兆子痫[RR1.55（95CI：1.14-2.12）；P=0.006]，妊娠期高血压[RR1.47（95CI：1.20-1.79）；P=0.0001]，胎龄大（LGA）[RR1.32（95CI：1.13-1.54）；P=0.0004]，巨大儿[RR1.29(95CI:1.15-1.44);P<0.001]。然而,在上述门槛下，早产率，下段剖宫产术（LSCS），小于胎龄（SGA），和新生儿低血糖没有明显升高。孕早期FPG≥5.6mmol/L（100mg/dL）与巨大儿的发生相关[RR1.47（95％CI：1.22-1.79）;P<0.0001]，LGA[RR1.43（95CI：1.24-1.65）；P<0.00001]，和早产[RR1.51（95CI：1.15-1.98）；P=0.003]，但不是SGA和LSCS.
结论：只有一项研究报告孕早期FPG为6.1mmol/L（110mg/dL），因此没有被分析。
结论：24-28周时发生GDM的风险随妊娠早期FPG升高而线性增加。妊娠早期FPG截止值分别为5.1mmol/L（92mg/dL）和5.6mmol/L（100mg/dL），可预测几种不良妊娠结局。
目的：荟萃分析的主要结果是分析妊娠早期FPG升高是否可以预测24-28周时GDM的发展。次要结果是确定常用的FPG截止值5.1mmol/L（92mg/dL），5.6mmol/L（100mg/dL），6.1mmol/L（110mg/dL）与不良妊娠事件相关。
方法：在数据库中搜索了从2010年开始发表的文章，以研究孕早期FPG与胎儿不良结局之间的关系。
方法：共有16项研究，涉及115,899例妊娠，符合纳入标准。
方法：患GDM的妇女早孕FPG明显高于未患GDM的妇女[MD0.29mmoL/l(5mg/dL);95%CI:0.21-0.38;P<0.00001]。孕早期FPG≥5.1mmol/L(92mg/dL)预测24-28周时GDM的发展[RR3.93(95%CI:2.67-5.77);P<0.0000],先兆子痫[RR1.55（95CI：1.14-2.12）；P=0.006]，妊娠期高血压[RR1.47（95CI：1.20-1.79）；P=0.0001]，胎龄大（LGA）[RR1.32（95CI：1.13-1.54）；P=0.0004]，巨大儿[RR1.29(95CI:1.15-1.44);P<0.001]。然而,在上述门槛下，早产率，下段剖宫产术（LSCS），小于胎龄（SGA），和新生儿低血糖没有明显升高。孕早期FPG≥5.6mmol/L（100mg/dL）与巨大儿的发生相关[RR1.47（95％CI：1.22-1.79）;P<0.0001]，LGA[RR1.43（95CI：1.24-1.65）；P<0.00001]，和早产[RR1.51（95CI：1.15-1.98）；P=0.003]，但不是SGA和LSCS.
结论：只有一项研究报告孕早期FPG为6.1mmol/L（110mg/dL），因此没有被分析。
结论：24-28周时发生GDM的风险随妊娠早期FPG升高而线性增加。妊娠早期FPG截止值分别为5.1mmol/L（92mg/dL）和5.6mmol/L（100mg/dL），可预测几种不良妊娠结局。
