Study On The Correlation Between Glucose And Hemoglobin Concentration During Pregnancy And The Risk Of Preterm Birth

Objective:Analysis of the association between hyperglycemia,anemia and high hemoglobin levels and the risk of preterm delivery for different gestational periods,and explores the combined effect of glycemia and hemoglobin on preterm birth,aiming to provide clues for the identification of risk factors for preterm birth and provide a scientific basis for preterm birth prevention to improve the quality of life of newborns.Methods:A prospective cohort study was used to collect pregnant women who were enrolled early and were able to undergo a full-term maternity checkup at the Maanshan Maternal and Child Health Hospital from April 2021 to August 2021 and were able to track their birth outcomes.Data on general demographic characteristics,disease history,life behavior during pregnancy,and pre-pregnancy weight and fasting glucose levels and hemoglobin concentrations at all stages of pregnancy were collected from pregnant women.Binary logistic regression was used to analyze the association between blood glucose levels and hemoglobin concentrations and preterm birth,and restricted cubic splines were used to analyze the dose-response relationship between blood glucose levels and hemoglobin concentrations and preterm birth.Results:1.Basic information of the research object A total of 2727 pregnant women were recruited,excluding those with missing birth outcomes,age information,pre-pregnancy BMI data,fasting glucose,hemoglobin concentration,those with twin births,hepatitis B carriers,syphilis positives,neonatal malformations,and those with missing abnormal thyroid function conditions,and finally 2026 pregnant women were included.2.Correlation analysis of blood glucose level and hemoglobin concentration during pregnancy with preterm birth The risk of preterm delivery was2.41 times higher in the hyperglycemic group than in the normoglycemic group in late pregnancy（OR=2.41,95%CI:1.30-4.45）;6.34 times higher in the group with high hemoglobin than in the group with normal hemoglobin in mid-pregnancy（OR=6.34,95%CI:1.25-32.22）and 6.89 times higher in the group with high hemoglobin than in the group with normal hemoglobin in late pregnancy（OR=6.89,95%CI:1.80-26.35）.The risk of preterm delivery was 6.89 times higher in the group with high hemoglobin in late pregnancy than in the group with normal hemoglobin（OR=6.89,95%CI:1.80-26.35）.There was a U-shaped relationship between hemoglobin concentration in the third trimester and the risk of preterm birth.3.Combined effects of blood glucose level and hemoglobin concentration during pregnancy on preterm birth The risk of preterm delivery was 5.87 times higher in the group with normal blood glucose and high hemoglobin than in the group with normal blood glucose and normal hemoglobin in early pregnancy（OR=5.87,95%CI:1.20-28.70）.The risk of preterm delivery was 6.84 times（OR=6.84,95%CI:1.11-30.74）and 6.68 times（OR=6.68,95%CI:2.13-20.92）higher in the group with normal blood glucose and high hemoglobin than in the group with normal blood glucose and normal hemoglobin in late pregnancy,respectively.There was an interaction between hyperglycemia and anemia on the occurrence of preterm delivery at late pregnancy compared to controls(P_interaction<0.05).Conclusion:The incidence of preterm birth in Maanshan is close to that investigated by scholars in other regions of China.Blood glucose level in late pregnancy affects the occurrence of preterm birth,and hemoglobin concentration in mid-and late pregnancy affects the occurrence of preterm birth.There is a U-shaped relationship between hemoglobin concentrations and the risk of preterm birth occurrence.In late pregnancy,there is a combined effect of hyperglycemia and anemia on the occurrence of preterm labor.Therefore,it is still important to monitor maternal glucose and hemoglobin during pregnancy,and in addition to this,it is necessary to actively identify those potential harmful factors that may affect glucose and hemoglobin,such as poor dietary habits,pre-pregnancy overweight and obesity,and insufficient nutrient supplementation,in order to reduce the occurrence of adverse pregnancy outcomes,improve the quality of life,and reduce the medical burden and economic costs.