1231-P: Decreased Complexity of Glucose Time Series Index Associated with Adverse Pregnancy Outcomes in Patients with Gestational Diabetes Mellitus—A Retrospective Cohort Study

Introduction & Objective: According to previous researches, the complexity of glucose time series index (CGI) may be a new indicator of glucose homeostasis. We aimed to investigate the relationship between the CGI during pregnancy and adverse pregnancy outcomes in gestational diabetes mellitus (GDM) patients.

Methods: In this retrospective cohort study, a total of 388 singleton-pregnant patients with GDM were recruited and underwent continuous glucose monitoring (CGM) at a median of 26.86 gestational weeks. The CGI was measured with refined composite multiscale entropy based on CGM data. Participants were categorized into tertiles according to CGI at baseline (CGI <2.32; CGI: 2.32-3.10; CGI ≥3.10). Logistic regression was used to assess the association of the CGI with composite adverse outcomes and large for gestational age (LGA). The CGI’s discrimination performance was estimated using receiver operating characteristic (ROC) analysis.

Results: Of the 388 GDM patients, 71 (18.3%) had LGA infants, and 63 (16.2%) had composite adverse outcomes. Compared to those with a high CGI (CGI ≥3.10), patients with a low CGI (CGI <2.32) had higher risks of composite adverse outcomes (OR: 9.87, 95% CI: 3.76-25.88) and LGA (OR: 11.92, 95% CI: 3.88-36.59) after adjusting for confounders. In ROC analysis, the CGI showed significantly better performance than the HbA1c level, time in range and coefficient of variation in predicting adverse pregnancy outcomes (all p < 0.05).

Conclusion: A lower CGI during pregnancy was associated with composite adverse outcomes and LGA. The CGI, a novel glucose homeostasis predictor, seems to be superior to conventional glucose indicators for predicting adverse pregnancy outcomes in GDM patients.