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Study Links Prediabetes in Youth to Adverse Pregnancy Outcomes
A new study from researchers at Mount Sinai has identified a significant connection between prediabetes in younger individuals and negative pregnancy outcomes later in life. Published in JAMA Network Open on September 24, these findings could reshape how healthcare providers approach screening and counseling for young people regarding blood glucose levels, ultimately aiming to reduce maternal and neonatal health risks.
Prediabetes, characterized by elevated blood sugar levels that are not yet high enough to qualify as type 2 diabetes, is a serious health issue. This condition predisposes individuals to much higher risks of heart disease and stroke. Alarmingly, the prevalence of prediabetes among American youth has surged, with reports indicating it has doubled over the past decade, now affecting nearly one-third of individuals aged 12 to 19 years, according to JAMA Pediatrics.
The study conducted by Mount Sinai focuses on the implications of prediabetes prior to conception among adolescents and young adults—demographics particularly susceptible to unplanned pregnancies and often lacking access to preconception health guidance.
Through a comprehensive retrospective cohort study involving over 14,000 individuals aged 10 to 24, researchers analyzed data compiled from the New York City birth registry, hospital discharge records, and the A1C registry, covering the years from 2009 to 2017. Participants were included if they had no prior diabetes diagnosis and underwent at least one hemoglobin A1c (HbA1c) test before their first child. The findings revealed that young individuals with preconception prediabetes faced more than double the risk of developing gestational diabetes during their first pregnancy. Additionally, the risk of hypertensive disorders during pregnancy, including gestational hypertension and preeclampsia, increased by 18 percent for those affected, along with a higher likelihood of experiencing preterm deliveries.
The study further analyzed the specific HbA1c levels that were most indicative of gestational diabetes risk among adolescents and young adults. The results suggested a slightly lower optimal threshold for the youth group compared to adults, noted as 5.6 percent versus 5.7 percent. The researchers emphasized that their findings underscore the urgent need for established clinical guidelines regarding the screening and counseling of young individuals presenting with elevated blood glucose levels without additional risk factors.
“The absence of standardized treatment guidelines for preconception prediabetes in adolescents could signify a lost opportunity to prevent complications during pregnancy,” stated Dr. Katharine McCarthy, MPH, the study’s corresponding author and Assistant Professor of Population Health Science and Policy, along with Obstetrics, Gynecology, and Reproductive Science at the Icahn School of Medicine at Mount Sinai. “Our findings advocate for expanded screening of hemoglobin A1c prior to conception as a proactive approach to mitigate excess cardiometabolic risks earlier in an individual’s life.”
The research team plans to explore potential school-based policies and interventions that might lessen risks associated with cardiovascular and metabolic health in adolescence, ultimately aiming to enhance overall pregnancy and long-term health outcomes.
Collaboration with researchers from the Columbia University Mailman School of Public Health, the NYC Department of Health and Mental Hygiene, and Stamford Hospital’s Department of Maternal and Fetal Medicine contributed to this important study. The research received backing from various grants from the National Institutes of Health.
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