Plasma glycemic measures and fecundability in a Singapore preconception cohort study
Plasma glycemic measures and fecundability in a Singapore preconception cohort study
Objective: To examine the association between plasma glycemia in women attempting to conceive and fecundability, as measured by time to pregnancy. Design: Prospective preconception population-based study. Setting: Hospital. Patient(s): Asian preconception women, 18–45 years old, attempting conception for ≤12 cycles at study entry. Intervention(s): None. Main Outcome Measure(s): We ascertained time to pregnancy within a year of glycemic assessment in menstrual cycles. We estimated fecundability ratios (FRs) and 95% confidence intervals using discrete-time proportional hazards models, adjusting for age, ethnicity, education, body mass index, and cycle regularity and accounting for left truncation and right censoring. Result(s): We studied a population sample of 766 women from the Singapore Preconception Study of Long-Term Maternal and Child Outcomes prospective cohort. Compared with women with normoglycemia, women with dysglycemia (prediabetes and diabetes, defined by the American Diabetes Association) had a lower FR (0.56). Compared with the respective lowest quintiles, women in the highest quintile of fasting glucose (≥5.1 mmol/L) had an FR of 0.60, while women in the highest 2-hour postload glucose quintile (≥6.9 mmol/L) had an FR of 0.66. Overall, the FRs decreased generally across the range of fasting and 2-hour plasma glucose. Glycated hemoglobin was not associated with fecundability. Conclusion(s): Increasing preconception plasma glucose is associated with reduced fecundability, even within the normal range of glucose concentrations. Clinical Trial Registration Number: NCT03531658.
Diabetes, HbA1c, fertility, preconception, time to pregnancy
138-147
Loy, See Ling
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Ku, Chee Wai
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Lai, Ada En Qi
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Choo, Xin Hui
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Ho, Angela Hui Min
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Cheung, Yin Bun
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Godfrey, Keith
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Chong, Yap-Seng
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Gluckman, Peter D.
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Shek, Lynette Pei-Chi
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Tan, Kok Hian
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Yap, Fabian
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Chan, Shiao-Yng
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Chan, Jerry Kok Yen
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1 January 2021
Loy, See Ling
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Ku, Chee Wai
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Lai, Ada En Qi
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Choo, Xin Hui
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Ho, Angela Hui Min
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Cheung, Yin Bun
c9beaf35-87d8-47f0-b41e-729e7820f991
Godfrey, Keith
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Chong, Yap-Seng
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Gluckman, Peter D.
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Shek, Lynette Pei-Chi
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Tan, Kok Hian
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Yap, Fabian
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Chan, Shiao-Yng
3c9d8970-2cc4-430a-86a7-96f6029a5293
Chan, Jerry Kok Yen
42e59d61-c3d1-486b-b33a-22c4645acf12
Loy, See Ling, Ku, Chee Wai, Lai, Ada En Qi, Choo, Xin Hui, Ho, Angela Hui Min, Cheung, Yin Bun, Godfrey, Keith, Chong, Yap-Seng, Gluckman, Peter D., Shek, Lynette Pei-Chi, Tan, Kok Hian, Yap, Fabian, Chan, Shiao-Yng and Chan, Jerry Kok Yen
(2021)
Plasma glycemic measures and fecundability in a Singapore preconception cohort study.
Fertility and Sterility, 115 (1), .
(doi:10.1016/j.fertnstert.2020.07.014).
Abstract
Objective: To examine the association between plasma glycemia in women attempting to conceive and fecundability, as measured by time to pregnancy. Design: Prospective preconception population-based study. Setting: Hospital. Patient(s): Asian preconception women, 18–45 years old, attempting conception for ≤12 cycles at study entry. Intervention(s): None. Main Outcome Measure(s): We ascertained time to pregnancy within a year of glycemic assessment in menstrual cycles. We estimated fecundability ratios (FRs) and 95% confidence intervals using discrete-time proportional hazards models, adjusting for age, ethnicity, education, body mass index, and cycle regularity and accounting for left truncation and right censoring. Result(s): We studied a population sample of 766 women from the Singapore Preconception Study of Long-Term Maternal and Child Outcomes prospective cohort. Compared with women with normoglycemia, women with dysglycemia (prediabetes and diabetes, defined by the American Diabetes Association) had a lower FR (0.56). Compared with the respective lowest quintiles, women in the highest quintile of fasting glucose (≥5.1 mmol/L) had an FR of 0.60, while women in the highest 2-hour postload glucose quintile (≥6.9 mmol/L) had an FR of 0.66. Overall, the FRs decreased generally across the range of fasting and 2-hour plasma glucose. Glycated hemoglobin was not associated with fecundability. Conclusion(s): Increasing preconception plasma glucose is associated with reduced fecundability, even within the normal range of glucose concentrations. Clinical Trial Registration Number: NCT03531658.
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Accepted/In Press date: 9 July 2020
e-pub ahead of print date: 15 October 2020
Published date: 1 January 2021
Additional Information:
Funding Information:
Supported by the Singapore National Research Foundation under its Translational and Clinical Research Flagship Programme and administered by the Singapore Ministry of Health’s National Medical Research Council (NMRC), Singapore, NMRC/TCR/004-NUS/2008 and NMRC/TCR/012-NUHS/2014; the Singapore Institute for Clinical Sciences , Agency for Science, Technology and Research (A ∗ STAR), Singapore; the Singapore National Medical Research Council’s Clinician Scientist Award (NMRC/CSA-INV/0010/2016 to S.-Y.C.); and the Singapore National Medical Research Council (CSA(SI)/008/2016 to J.K.Y.C.). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Funding Information:
Supported by the Singapore National Research Foundation under its Translational and Clinical Research Flagship Programme and administered by the Singapore Ministry of Health's National Medical Research Council (NMRC), Singapore, NMRC/TCR/004-NUS/2008 and NMRC/TCR/012-NUHS/2014; the Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A?STAR), Singapore; the Singapore National Medical Research Council's Clinician Scientist Award (NMRC/CSA-INV/0010/2016 to S.-Y.C.); and the Singapore National Medical Research Council (CSA(SI)/008/2016 to J.K.Y.C.). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Funding Information:
S.L.L. has nothing to disclose. C.W.K. has nothing to disclose. A.E.Q.L. has nothing to disclose. X.H.C. has nothing to disclose. A.H.M.H. has nothing to disclose. Y.B.C. has nothing to disclose. K.M.G. reports a grant from Nestec; reimbursement for speaking at Nestle Nutrition Institute conferences; issued patents for predictive use of CpG methylation, phenotype prediction, and vitamin B6 in maternal administration for the prevention of overweight or obesity in the offspring; and patents pending for maternal nutrition composition and composition and its use. Y.-S.C. reports grants from Singapore Ministry of Health’s National Medical Research Council (NMRC), Singapore (grant nos. NMRC/TCR/004-NUS/2008; NMRC/TCR/012-NUHS/2014), nonfinancial support as research and manpower support from Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A∗STAR), Singapore, during the conduct of the study; research funding from Abbott Nutrition, Nestle, and Danone, outside the submitted work; and has a patent for vitamin B12 and its use for gestational diabetes mellitus pending (EU Patent Application 15170911.0), a patent for myo-inositol and one or more probiotics and use for type II diabetes pending (EU Patent Application 15170902.9), a patent for vitamin B12 and use for type II diabetes pending (EU Patent Application 15170906.0), and a patent for myo-inositol and one or more probiotics and use for gestational diabetes mellitus issued (EU Patent Application 15170915.1). P.D.G. reports grants and other from Singapore Agency for Science, Technology and Research, during the conduct of the study. L.P.-C.S. has nothing to disclose. K.H.T. has nothing to disclose. F.K.P.Y. reports personal fees from Abbott Pharmaceuticals, outside the submitted work. S.-Y.C. has nothing to disclose. J.K.Y.C. has nothing to disclose. S.-Y.C. reports grants from Nestle, Danone, and Abbott Nutrition, outside the submitted work.
Publisher Copyright:
© 2020 American Society for Reproductive Medicine
Keywords:
Diabetes, HbA1c, fertility, preconception, time to pregnancy
Identifiers
Local EPrints ID: 442546
URI: http://eprints.soton.ac.uk/id/eprint/442546
ISSN: 0015-0282
PURE UUID: 39a7eab5-4756-4c60-9324-a7ce1d78d2d2
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Date deposited: 17 Jul 2020 16:35
Last modified: 17 Mar 2024 05:44
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Contributors
Author:
See Ling Loy
Author:
Chee Wai Ku
Author:
Ada En Qi Lai
Author:
Xin Hui Choo
Author:
Angela Hui Min Ho
Author:
Yin Bun Cheung
Author:
Yap-Seng Chong
Author:
Peter D. Gluckman
Author:
Lynette Pei-Chi Shek
Author:
Kok Hian Tan
Author:
Fabian Yap
Author:
Shiao-Yng Chan
Author:
Jerry Kok Yen Chan
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