Longitudinal changes in the continuous glucose profile measured by the CGMS® in healthy pregnant women and determination of cut-off values

Siegmund, Tina; Rad, Neda Talai; Ritterath, Claudia; Siebert, Gerda; Henrich, Wolfgang; Buhling, Kai J.

doi:10.1016/j.ejogrb.2007.12.006

« Previous Next »European Journal of Obstetrics & Gynecology and Reproductive Biology
Volume 139, Issue 1 , Pages 46-52, July 2008

Longitudinal changes in the continuous glucose profile measured by the CGMS^® in healthy pregnant women and determination of cut-off values

Tina Siegmund
- Clinic of Obstetrics, Charité – Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany
Neda Talai Rad
- Clinic of Obstetrics, Charité – Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany
Claudia Ritterath
- Clinic of Obstetrics, Charité – Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany
Gerda Siebert
- Institute of Medical Biometry, Universitätsmedizin Berlin, Berlin, Germany
Wolfgang Henrich
- Clinic of Obstetrics, Charité – Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany
Kai J. Buhling
- Clinic of Obstetrics, Charité – Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany
- Department of Gynecologic Endocrinology, Universitätsfrauenklinik Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
- Corresponding author. Tel.: +49 30 4505 64293; fax: +49 30 4505 64901.

Received 4 March 2007; received in revised form 12 November 2007; accepted 17 December 2007. published online 13 February 2008.

Abstract

Objective

This longitudinal study performed continuous evaluation of daily blood glucose level profiles in healthy normal-weight pregnant patients during various gestational age and determined normal levels.

Study design

Thirty-two healthy normal-weight pregnant women received a continuous glucose monitoring system (CGMS^®) device for periods of 72h in the 16th, 22nd, 30th and 36th weeks of gestational age and at 6 weeks after delivery. All observations took place in the outpatient clinic of the Charité hospital. The daily blood glucose level profiles obtained with the CGMS provided pre- and postprandial blood glucose levels and a mean glucose value for a 24-h period. Caloric intake was determined using detailed food logs. Additionally, a fetal biometry and an measurement of maternal weight were performed at each visit. The correlation was tested using Spearman's test.

Results

The average age of the study subjects was 29.6±4.5. Average pre-pregnancy BMI was 22.4±2.5kg/m². The births occurred on average in the 40th week of pregnancy. Average caloric intake was 2223±356kcal. No significant changes in caloric intake were observed during the course of the study. The blood glucose levels showed a significant rise throughout the course of the pregnancy, going from 4.84±0.4mmol/l (87.2±7.2mg/dl) during the 30th week of pregnancy to 5.22±0.5mmol/l (94.0±9.0mg/dl) during the 36th week (p=0.002). Postpartum levels were 5.20±0.5mmol/l (93.7±9.0mg/dl) (p=0.51). Fasting blood glucose levels did not change during the course of the pregnancy. A noticeable aspect were the significantly increased fasting postpartum levels with 5.02±0.6mmol/l (90.4±10.8mg/dl) (p=0.00). Analysis of the postprandial glucose levels confirmed a rise from 5.30±0.6mmol/l (95.5±10.8mg/dl) in the 16th week to 6.14±0.7mmol/l (110.6±12.6mg/dl) in the fourth study phase (36th week), and a decrease after the birth to 5.59±0.6mmol/l (100.7±10.8mg/dl). These measurements were adapted to the gestational age.

Conclusion

Continuous measured glucose levels rose during the pregnancy in healthy pregnant women in spite of normal pre-pregnancy metabolism and unchanged carbohydrate intake during gestation. These results suggest the necessity of gestational-age-dependent cut-off values.

Keywords: Continuous glucose monitoring system (CGMS), Glucose levels, Nutrition, Pregnancy