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

Publication Title

Sci Rep

Authors

Subeen Hong
Kyung A Lee
Young Mi Jung
Heechul Jeong
Ji-Hee Sung
Hyun-Joo Seol
Won Joon Seong
Soo Ran Choi
Joon Ho Lee
Seung Chul Kim
Sae-Kyoung Choi
Ji Young Kwon
Hyun Soo Park, Family Medicine Residency, Providence St Joseph Eureka Hospital, Eureka, CA, 95501, USA.Follow
Hyun Sun Ko
Geum Joon Cho

Document Type

Article

Publication Date

11-20-2025

Keywords

Humans; Female; Pregnancy; Adult; Blood Glucose; Fasting; Congenital Abnormalities; Pregnancy in Diabetics; Republic of Korea; Risk Factors; Cohort Studies; Diabetes mellitus; Fasting plasma glucose; Fetal malformation; Pregnant women.; california; eureka

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].

Area of Special Interest

Women & Children

Area of Special Interest

Kidney & Diabetes

Specialty/Research Institute

Obstetrics & Gynecology

Specialty/Research Institute

Endocrinology

DOI

10.1038/s41598-025-24954-0