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Pre-pregnancy maternal fasting plasma glucose levels in relation to time to pregnancy among the couples attempting first pregnancy

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机构: [1]National Research Institute for Family Planning, Beijing, China. [2]National Human Genetic Resources Center, Beijing, China. [3]Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China. [4]Department of Medical Record Management, The Affiliated YanAn Hospital of Kunming Medical University, Yunnan, China. [5]Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, PA, USA. [6]Department of Maternal and Child Health, National Health Commission of the People's Republic of China, Beijing, China. [7]Graduate School of Peking Union Medical College, Beijing, China
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关键词: pre-pregnancy / diabetes / impaired fasting glucose / time to pregnancy / fecundability

摘要:
What is the relationship between pre-pregnancy maternal glucose levels and fecundability in Chinese couples?Elevated pre-pregnancy maternal glucose levels were associated with fecundability, as reflected by prolonged time to pregnancy (TTP) among the couples with no prior gravidity.Based on the National Free Pre-conception Check-up Projects supported by the Chinese government, 2 226 048 eligible couples attempting first pregnancy and participating in the project from 2015 to 2016 were included. They were followed-up for 1 year or until they reported pregnancy.The Kaplan-Meier method was used to estimate the cumulative pregnancy rate in each menstrual cycle, and the discrete-time analogue of the Cox models was used to estimate the fecundability odds ratios (FORs) and 95% CIs by different pre-pregnancy maternal glucose levels (impaired fasting glucose (IFG) or diabetes as compared to normal).The cumulative pregnancy rate for 12 cycles of the normal fasting plasma glucose (FPG) level group was 42.29%, significantly higher than that of the IFG (35.52%) and diabetes groups (31.52%). After adjusting for confounding factors, the FORs were 0.82 (95% CI: 0.81-0.83) and 0.74 (95% CI: 0.72-0.76) for the IFG and diabetes groups, respectively, as compared to the normal group. The association between pre-pregnancy maternal FPG levels and the FORs was non-linear, and the optimal FPG level for greatest fecundability (shortest TTP) was 3.90-4.89 mmol/L.The findings from this register-based cohort study require cautious interpretation given that information bias would be inevitable for single FPG measurements and for TTP calculations that were based on telephone follow-up information. Additionally, because couples who achieved pregnancy during their first menstrual cycle in the study were excluded, the pregnancy rates reported were low and possibly biased.The current report suggests that elevated pre-pregnancy maternal glucose levels were associated with prolonged TTP. Early evaluation and preventive treatment for female partners with IFG or diabetes in a pre-pregnancy examination are necessary.Funding was provided by the National Key Research and Development Program of China (grants No. 2016YFC1000300 and 2016YFC1000307), the National Natural Science Foundation of China (grant No. 81872634), the CAMS Innovation Fund for Medical Sciences (grant No. 2018-I2M-1-004), the National Human Genetic Resources Sharing Service Platform (grant No. 2005DKA21300) and the National Population and Reproductive Health Science Data Center (grant No. 2005DKA32408), People's Republic of China. The authors have no conflicts of interest to declare.N/A.© The Author(s) 2019. Published by Oxford University Press.

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出版当年[2019]版:
大类 | 2 区 医学
小类 | 1 区 妇产科学 1 区 生殖生物学
最新[2025]版:
大类 | 1 区 医学
小类 | 1 区 妇产科学 1 区 生殖生物学
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出版当年[2018]版:
Q1 OBSTETRICS & GYNECOLOGY Q1 REPRODUCTIVE BIOLOGY
最新[2023]版:
Q1 OBSTETRICS & GYNECOLOGY Q1 REPRODUCTIVE BIOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2018版] 出版当年五年平均 出版前一年[2017版] 出版后一年[2019版]

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第一作者机构: [1]National Research Institute for Family Planning, Beijing, China. [2]National Human Genetic Resources Center, Beijing, China.
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通讯机构: [1]National Research Institute for Family Planning, Beijing, China. [2]National Human Genetic Resources Center, Beijing, China. [3]Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China. [7]Graduate School of Peking Union Medical College, Beijing, China [*1]School of Public Health, Southeast University, No. 87 Dingjiaqiao Rd, Gulou District, Nanjing, Jiangsu, China [*2]National Human Genetic Resources Center, National Research Institute for Family Planning, No. 12 Dahuisi Rd, Haidian District, Beijing, China
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