Characterizing maternal glycemic control: a more informative approach using semiparametric regression.

MedStar author(s):
Citation: Journal of Maternal-Fetal & Neonatal Medicine. 25(1):15-9, 2012 Jan.PMID: 21955072Institution: MedStar Health Research InstituteForm of publication: Journal ArticleMedline article type(s): Journal Article | Research Support, N.I.H., Extramural | Research Support, Non-U.S. Gov'tSubject headings: *Blood Glucose/an [Analysis] | *Diabetes Mellitus, Type 1/bl [Blood] | *Pregnancy in Diabetics/bl [Blood] | *Regression Analysis | Birth Weight | Female | Fetal Macrosomia/bl [Blood] | Gestational Age | Humans | PregnancyLocal holdings: Available online through MWHC library: 2013 to the presentISSN:
  • 1476-4954
Name of journal: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal ObstetriciansAbstract: CONCLUSIONS: Semiparametric regression techniques enabled synchronous inclusion of all glucose concentrations using multi-step modeling. We identified specific periods of gestation where maternal glucose concentrations differ for the LGA and AGA developing fetus, with greatest distinctions appearing in first and third trimesters. Novel statistical approaches that examine time-specific behavior garner insight into longitudinal assessment of maternal glycemic control.METHODS: We conducted a secondary analysis of data from an interdisciplinary program of diabetes in pregnancy of women with type 1 diabetes. Semiparametric regression was used to characterize glucose concentrations measured using reflectance meters throughout pregnancy by examining the time-specific association of maternal glucose with delivery of a large for gestational age (LGA) baby.OBJECTIVE: To characterize glucose concentrations measured throughout pregnancy in women with type 1 diabetes using semiparametric regression analysis to examine the gestational time-specific association with fetal outcome.RESULTS: The optimal model demonstrated that time-specific differences in glycemic profiles of mothers who had LGA versus AGA babies 130912d at various rates across gestation (p=0.0007). AGA glucose profiles exceeded LGA profiles in the first trimester and mid pregnancy; conversely LGA glucose profiles exceeded AGA profiles initially during the third trimester. Differences were based on examination of 95% simultaneous confidence bands.All authors: Khoury JC, Miodovnik M, Ren Y, Rosenn B, Sucharew HJ, Vandyke RDigital Object Identifier: Date added to catalog: 2013-09-17
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article Available 21955072

Available online through MWHC library: 2013 to the present

CONCLUSIONS: Semiparametric regression techniques enabled synchronous inclusion of all glucose concentrations using multi-step modeling. We identified specific periods of gestation where maternal glucose concentrations differ for the LGA and AGA developing fetus, with greatest distinctions appearing in first and third trimesters. Novel statistical approaches that examine time-specific behavior garner insight into longitudinal assessment of maternal glycemic control.

METHODS: We conducted a secondary analysis of data from an interdisciplinary program of diabetes in pregnancy of women with type 1 diabetes. Semiparametric regression was used to characterize glucose concentrations measured using reflectance meters throughout pregnancy by examining the time-specific association of maternal glucose with delivery of a large for gestational age (LGA) baby.

OBJECTIVE: To characterize glucose concentrations measured throughout pregnancy in women with type 1 diabetes using semiparametric regression analysis to examine the gestational time-specific association with fetal outcome.

RESULTS: The optimal model demonstrated that time-specific differences in glycemic profiles of mothers who had LGA versus AGA babies 130912d at various rates across gestation (p=0.0007). AGA glucose profiles exceeded LGA profiles in the first trimester and mid pregnancy; conversely LGA glucose profiles exceeded AGA profiles initially during the third trimester. Differences were based on examination of 95% simultaneous confidence bands.

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