{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:07:34Z","timestamp":1792026454093,"version":"4.4.0"},"reference-count":35,"publisher":"American Diabetes Association","issue":"1","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2016,1,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Recent guidelines recommend testing at &amp;lt;24 weeks of gestation for maternal dysglycemia in \u201chigh-risk\u201d women. Evidence to support the early identification and treatment of gestational diabetes mellitus (GDM) is, however, limited. We examined the prevalence, clinical characteristics, and pregnancy outcomes of high-risk women with GDM diagnosed at &amp;lt;24 weeks of gestation (early GDM) and those with pre-existing diabetes compared with GDM diagnosed at \u226524 weeks of gestation, in a large treated multiethnic cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>Outcomes from 4,873 women attending a university hospital antenatal diabetes clinic between 1991 and 2011 were examined. All were treated to standardized glycemic targets. Women were stratified as pre-existing diabetes (n = 65) or GDM diagnosed at &amp;lt;12 weeks of gestation (n = 68), at 12\u201323 weeks of gestation (n = 1,247), or at \u226524 weeks of gestation (n = 3,493).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Hypertensive disorders in pregnancy including pre-eclampsia, preterm delivery, cesarean section, and neonatal jaundice (all P &amp;lt; 0.001) were more prevalent in women with pre-existing diabetes and early GDM. Macrosomia (21.8% vs. 20.3%, P = 0.8), large for gestational age (39.6% vs. 32.8%, P = 0.4), and neonatal intensive care admission (38.5% vs. 39.7%, P = 0.9) in women in whom GDM was diagnosed at &amp;lt;12 weeks of gestation were comparable to rates seen in women with pre-existing diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Despite early testing and current best practice treatment, early GDM in high-risk women remains associated with poorer pregnancy outcomes. Outcomes for those in whom GDM was diagnosed at &amp;lt;12 weeks of gestation approximated those seen in pre-existing diabetes. These findings indicate the need for further studies to establish the efficacy of alternative management approaches to improve outcomes in these high-risk pregnancies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc15-0433","type":"journal-article","created":{"date-parts":[[2015,12,9]],"date-time":"2015-12-09T09:06:04Z","timestamp":1449651964000},"page":"75-81","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":226,"title":["Gestational Diabetes Mellitus in Early Pregnancy: Evidence for Poor Pregnancy Outcomes Despite Treatment"],"prefix":"10.2337","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6843-6247","authenticated-orcid":false,"given":"Arianne N.","family":"Sweeting","sequence":"first","affiliation":[{"name":"Diabetes Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia"},{"name":"Discipline of Medicine, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glynis P.","family":"Ross","sequence":"additional","affiliation":[{"name":"Diabetes Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia"},{"name":"Discipline of Medicine, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Hyett","sequence":"additional","affiliation":[{"name":"Department of High Risk Obstetrics, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia"},{"name":"Discipline of Obstetrics, Gynaecology and Neonatology, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynda","family":"Molyneaux","sequence":"additional","affiliation":[{"name":"Diabetes Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia"},{"name":"Discipline of Medicine, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Constantino","sequence":"additional","affiliation":[{"name":"Diabetes Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Jane","family":"Harding","sequence":"additional","affiliation":[{"name":"Diabetes Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jencia","family":"Wong","sequence":"additional","affiliation":[{"name":"Diabetes Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia"},{"name":"Discipline of Medicine, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2015,12,5]]},"reference":[{"key":"2022031221073226300_B1","doi-asserted-by":"crossref","first-page":"1991","DOI":"10.1056\/NEJMoa0707943","article-title":"Hyperglycemia and adverse pregnancy outcomes","volume":"358","author":"Metzger","year":"2008","journal-title":"N Engl J Med"},{"key":"2022031221073226300_B2","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1016\/S0140-6736(09)60515-8","article-title":"Gestational diabetes: the need for a common ground","volume":"373","author":"Reece","year":"2009","journal-title":"Lancet"},{"key":"2022031221073226300_B3","volume-title":"Mothers, Babies and Diseases in Later Life","author":"Barker","year":"1994"},{"key":"2022031221073226300_B4","doi-asserted-by":"crossref","first-page":"2288","DOI":"10.2337\/dc08-1038","article-title":"Sociodemographic correlates of the increasing trend in prevalence of gestational diabetes mellitus in a large population of women between 1995 and 2005","volume":"31","author":"Anna","year":"2008","journal-title":"Diabetes Care"},{"key":"2022031221073226300_B5","doi-asserted-by":"crossref","first-page":"2070","DOI":"10.2337\/dc06-2559a","article-title":"Maternal obesity and risk of gestational diabetes mellitus","volume":"30","author":"Chu","year":"2007","journal-title":"Diabetes Care"},{"key":"2022031221073226300_B6","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1111\/j.1467-789X.2008.00541.x","article-title":"Prepregnancy BMI and the risk of gestational diabetes: a systematic review of the literature with meta-analysis","volume":"10","author":"Torloni","year":"2009","journal-title":"Obes Rev"},{"key":"2022031221073226300_B7","doi-asserted-by":"crossref","first-page":"2477","DOI":"10.1056\/NEJMoa042973","article-title":"Effect of treatment of gestational diabetes mellitus on pregnancy outcomes","volume":"352","author":"Crowther","year":"2005","journal-title":"N Engl J Med"},{"key":"2022031221073226300_B8","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1056\/NEJMoa0902430","article-title":"A multicenter, randomized trial of treatment for mild gestational diabetes","volume":"361","author":"Landon","year":"2009","journal-title":"N Engl J Med"},{"key":"2022031221073226300_B9","doi-asserted-by":"crossref","first-page":"676","DOI":"10.2337\/dc10-0719","article-title":"International Association of Diabetes and Pregnancy Study Groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy","volume":"33","author":"Metzger","year":"2010","journal-title":"Diabetes Care"},{"key":"2022031221073226300_B10","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.diabres.2013.10.012","article-title":"Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy: a World Health Organization Guideline","volume":"103","author":"World Health Organization","year":"2014","journal-title":"Diabetes Res Clin Pract"},{"key":"2022031221073226300_B11","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.2337\/diacare.25.10.1681","article-title":"Fetal growth spurt and pregestational diabetic pregnancy","volume":"25","author":"Wong","year":"2002","journal-title":"Diabetes Care"},{"key":"2022031221073226300_B12","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1002\/(SICI)1096-9136(199602)13:2<170::AID-DIA8>3.0.CO;2-4","article-title":"Is macrosomia associated with poor glycaemic control in diabetic pregnancy","volume":"13","author":"Page","year":"1996","journal-title":"Diabet Med"},{"key":"2022031221073226300_B13","doi-asserted-by":"crossref","first-page":"1639","DOI":"10.2337\/dc09-0688","article-title":"First-trimester fasting hyperglycemia and adverse pregnancy outcomes","volume":"32","author":"Riskin-Mashiah","year":"2009","journal-title":"Diabetes Care"},{"key":"2022031221073226300_B14","doi-asserted-by":"crossref","first-page":"414","DOI":"10.7326\/M13-2905","article-title":"Screening for gestational diabetes mellitus: U.S. Preventive Services Task Force recommendation statement","volume":"160","author":"Moyer","year":"2014","journal-title":"Ann Intern Med"},{"key":"2022031221073226300_B15","unstructured":"Nankervis A, McIntyre HD, Moses R, et al. ADIPS Consensus Guidelines for the Testing and Diagnosis of Hyperglycaemia in Pregnancy in Australia and New Zealand (modified November 2014) [article online], 2014. Available from http:\/\/adips.org\/downloads\/2014ADIPSGDMGuidelinesV18.11.2014_000.pdf"},{"key":"2022031221073226300_B16","doi-asserted-by":"crossref","first-page":"93","DOI":"10.5694\/j.1326-5377.1998.tb140192.x","article-title":"Gestational diabetes mellitus-management guidelines","volume":"169","author":"Hoffman","year":"1998","journal-title":"Med J Aust"},{"key":"2022031221073226300_B17","first-page":"112","article-title":"ADS Position Statement: The diagnosis of gestational diabetes","volume-title":"Med J Aust","author":"Martin","year":"1991"},{"key":"2022031221073226300_B18","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1002\/(SICI)1096-9136(199608)13:8<748::AID-DIA164>3.0.CO;2-I","article-title":"Why does ethnicity affect prevalence of gestational diabetes? The underwater volcano theory","volume":"13","author":"Yue","year":"1996","journal-title":"Diabet Med"},{"key":"2022031221073226300_B19","doi-asserted-by":"crossref","first-page":"562","DOI":"10.2337\/dc12-1557","article-title":"Body composition is normal in term infants born to mothers with well-controlled gestational diabetes mellitus","volume":"36","author":"Au","year":"2013","journal-title":"Diabetes Care"},{"key":"2022031221073226300_B20","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1111\/j.1440-1754.1996.tb00965.x","article-title":"New South Wales population-based birthweight percentile charts","volume":"32","author":"Beeby","year":"1996","journal-title":"J Paediatr Child Health"},{"key":"2022031221073226300_B21","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1136\/bmj.38856.692986.AE","article-title":"Perinatal mortality and congenital anomalies in babies of women with type 1 or type 2 diabetes in England, Wales, and Northern Ireland: population based study","volume":"333","author":"Macintosh","year":"2006","journal-title":"BMJ"},{"key":"2022031221073226300_B22","doi-asserted-by":"crossref","first-page":"780","DOI":"10.2337\/dc11-1790","article-title":"The Hyperglycemia and Adverse Pregnancy Outcome study: associations of GDM and obesity with pregnancy outcomes","volume":"35","author":"Catalano","year":"2012","journal-title":"Diabetes Care"},{"key":"2022031221073226300_B23","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1016\/S0002-9378(00)70222-5","article-title":"Gestational diabetes mellitus diagnosed during early pregnancy","volume":"182","author":"Bartha","year":"2000","journal-title":"Am J Obstet Gynecol"},{"key":"2022031221073226300_B24","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.diabres.2007.12.008","article-title":"Detection and care of women with gestational diabetes mellitus from early weeks of pregnancy results in birth weight of newborn babies appropriate for gestational age","volume":"80","author":"Seshiah","year":"2008","journal-title":"Diabetes Res Clin Pract"},{"key":"2022031221073226300_B25","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/S0301-2115(02)00480-3","article-title":"Early diagnosis of gestational diabetes mellitus and prevention of diabetes-related complications","volume":"109","author":"Bartha","year":"2003","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"2022031221073226300_B26","first-page":"287.e1\u20136","article-title":"Diet-treated gestational diabetes mellitus: comparison of early vs routine diagnosis","volume-title":"Am J Obstet Gynecol","author":"Hawkins","year":"2008"},{"key":"2022031221073226300_B27","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1515\/JPM.2009.034","article-title":"Maternal and neonatal outcomes in early glucose tolerance testing in an obstetric population in New York city","volume":"37","author":"Most","year":"2009","journal-title":"J Perinat Med"},{"key":"2022031221073226300_B28","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1016\/S0002-9378(12)80023-8","article-title":"Maternal characteristics, neonatal outcome, and the time of diagnosis of gestational diabetes","volume":"167","author":"Berkowitz","year":"1992","journal-title":"Am J Obstet Gynecol"},{"key":"2022031221073226300_B29","first-page":"675","article-title":"Early gestational glucose screening and gestational diabetes","volume":"41","author":"Meyer","year":"1996","journal-title":"J Reprod Med"},{"key":"2022031221073226300_B30","first-page":"299","article-title":"Gestational diabetes: fasting and postprandial glucose as first prenatal screening tests in a high-risk population","volume":"52","author":"Agarwal","year":"2007","journal-title":"J Reprod Med"},{"key":"2022031221073226300_B31","doi-asserted-by":"crossref","first-page":"288","DOI":"10.2337\/diacare.14.4.288","article-title":"Diagnosis of gestational diabetes in early pregnancy","volume":"14","author":"Super","year":"1991","journal-title":"Diabetes Care"},{"key":"2022031221073226300_B32","first-page":"1113","article-title":"Pathophysiological characteristics and impact of obesity in women with early and late manifestation of gestational diabetes diagnosed by the International Association of Diabetes and Pregnancy Study Groups criteria","volume-title":"J Clin Endocrinol Metab","author":"Bozkurt","year":"2015"},{"key":"2022031221073226300_B33","doi-asserted-by":"crossref","first-page":"1858","DOI":"10.2337\/dc08-0039","article-title":"Maternal lipids as strong determinants of fetal environment and growth in pregnancies with gestational diabetes mellitus","volume":"31","author":"Schaefer-Graf","year":"2008","journal-title":"Diabetes Care"},{"key":"2022031221073226300_B34","doi-asserted-by":"crossref","first-page":"56","DOI":"10.2337\/dc12-0741","article-title":"The relative contribution of prepregnancy overweight and obesity, gestational weight gain, and IADPSG-defined gestational diabetes mellitus to fetal overgrowth","volume":"36","author":"Black","year":"2013","journal-title":"Diabetes Care"},{"key":"2022031221073226300_B35","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1089\/jwh.2010.2033","article-title":"Risk factor profile and pregnancy outcome in women with type 1 and type 2 diabetes mellitus","volume":"20","author":"Handisurya","year":"2011","journal-title":"J Womens Health (Larchmt)"}],"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/39\/1\/75\/624671\/dc150433.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/39\/1\/75\/624671\/dc150433.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,31]],"date-time":"2025-05-31T14:33:15Z","timestamp":1748701995000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/39\/1\/75\/31482\/Gestational-Diabetes-Mellitus-in-Early-Pregnancy"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,12,5]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2015,12,5]]},"published-print":{"date-parts":[[2016,1,1]]}},"URL":"https:\/\/doi.org\/10.2337\/dc15-0433","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"value":"0149-5992","type":"print"},{"value":"1935-5548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,12,5]]}}}