Prediabetes elevates the risk of cardiometabolic disorders, including diabetes, heart disease, and kidney damage. Adding more evidence to the far-reaching effects of prediabetes, researchers have now found that it can also negatively impact pregnancy outcomes in young adults.
When blood sugar levels are elevated, but not yet high enough to be classified as type 2 diabetes, the condition is called prediabetes. Studies have shown that early intervention, particularly through lifestyle changes, is crucial during the prediabetes stage to prevent its progression to diabetes and other serious conditions.
The rate of prediabetes among U.S. teens has doubled in the past decade, now affecting nearly one in three aged 12 to 19, according to the researchers of the latest study.
The research team discovered that having prediabetes before conception more than doubles the risk of developing gestational diabetes in the first pregnancy. Prediabetes during youth and adolescence is also tied to an 18% increased risk of hypertensive disorders during pregnancy, such as gestational hypertension and preeclampsia, or preterm delivery, according to the study results published in the journal JAMA Pediatrics.
The findings were based on data from more than 14,000 individuals from the New York City birth records, hospital discharge data, and A1C Registry data from 2009 to 2017. The participant pool had individuals between the ages of 10 and 24 years.
The researchers assessed hemoglobin A1c levels, which reflect average blood sugar over the past three months, to estimate the most accurate predictor of gestational diabetes in adolescents and young adults during their first pregnancy. The optimal threshold for younger individuals was slightly lower than that for adults (5.6 percent vs. 5.7 percent).
"This study is an important step in life-course cardiometabolic health to optimal pregnancy outcomes. The findings point to an opportunity to invest in adolescent health to promote later healthy pregnancies," said senior author Teresa Janevic in a news release.
Based on the findings researchers recommend establishing clear clinical guidance on screening and counseling young people with elevated blood glucose levels even without other risk factors.
"The lack of uniform preconception prediabetes treatment guidelines for adolescents may represent a missed opportunity to avert pregnancy-related complications. Our results support expanded preconception hemoglobin A1c screening as a mechanism to intervene on excess cardiometabolic risk earlier in the life course," said corresponding author Katharine McCarthy.
