{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T05:52:07Z","timestamp":1785909127908,"version":"3.56.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to investigate the association between cumulative glycemic exposure (CGE) during pregnancy and glycemic metabolism abnormality (GMA) at 4\u20137\u202fyears postpartum and to compare its predictive value with that of a single fasting blood glucose (FBG) measurement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective\u2013prospective cohort study, 120 pregnant women were included from an existing cohort. CGE was calculated using the trapezoidal rule, and subjects were categorized into tertiles. A logistic regression analysis evaluated the association between CGE and GMA, and restricted cubic splines were used to evaluate dose\u2013response relationships. The interaction between CGE and pre-pregnancy body mass index (BMI) was examined. Predictive performance was compared using receiver operating characteristic (ROC) curves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Higher CGE was associated with an increased incidence of GMA [tertile 1 (T1): 10.0%, T2: 35.0%, T3: 65.0%]. Each 1-unit increment in CGE independently increased GMA risk (odds ratio\u202f=\u202f1.040, 95% confidence interval: 1.01\u20131.07,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.028). Compared with T1, the risk of GMA was 3.85-fold higher in T2 and 15.82-fold higher in T3 (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.05). FBG at 8 and 24\u202fweeks, but not 34\u202fweeks, significantly predicted GMA. A non-linear dose\u2013response between CGE and GMA was observed (inflection point: 192.67\u202fmmol\/L\u00b7week). An additive interaction between CGE and pre-pregnancy BMI was observed. The combined model (CGE\u202f+\u202fpre-pregnancy BMI) provided the best prediction [area under the curve (AUC): 0.843, sensitivity: 85.5%, specificity: 79.1%].\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CGE during pregnancy is an independent predictor of postpartum GMA. In clinical practice, adding pre-pregnancy BMI improves risk stratification, supporting the early identification of high-risk women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>Identifier ChiCTR2300067592.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1876136","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T05:38:26Z","timestamp":1785908306000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between pregnancy cumulative glycemic exposure and postpartum glucose metabolism outcomes at 4\u20137\u202fyears: a cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Dan","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Peking University People\u2019s Hospital","place":["Beijing, China"]},{"name":"Department of Endocrinology, Peking University International Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Peking University International Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianbin","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Peking University International Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaomei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Peking University International Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linong","family":"Ji","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Peking University People\u2019s Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1016\/s0140-6736(24)00825-0","article-title":"Epidemiology and management of gestational diabetes","volume":"404","author":"Sweeting","year":"2024","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"102069","DOI":"10.1016\/j.beem.2025.102069","article-title":"Diagnosis of gestational diabetes: evidence and pitfalls","volume":"39","author":"Wong","year":"2025","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"112462","DOI":"10.1016\/j.diabres.2025.112462","article-title":"Gestational diabetes mellitus and its impact on maternal and neonatal outcomes in indigenous populations: a systematic review and 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