Study Links Prediabetes in Youth to Increased Pregnancy Risks

New research from Columbia Mailman School of Public Health and Mount Sinai School of Medicine has found that prediabetes among young people is linked to adverse pregnancy outcomes later in life. The study, published in JAMA Network Open, suggests that early intervention and screening for elevated blood sugar levels in adolescents could help reduce maternal and neonatal health risks.

“This study is an important step in tying lifecourse cardiometabolic health to optimal pregnancy outcomes,” said Teresa Janevic, PhD, associate professor of Epidemiology at Columbia University Mailman School of Public Health and senior author. “The findings point to an opportunity to invest in adolescent health to promote later healthy pregnancies.”

According to the study, prediabetes is a condition where blood sugar levels are higher than normal but not high enough to be classified as type 2 diabetes. It has been linked to increased risks of heart disease and stroke and disproportionately affects Hispanic, Black, and low-income individuals. According to JAMA Pediatrics, the rate of prediabetes among youth in the United States has doubled over the past decade, now affecting nearly one in three adolescents aged 12 to 19 years.

The researchers examined data from over 14,000 individuals aged 10 to 24, using information from New York City birth registry, hospital discharge, and A1C registry records between 2009 and 2017. Participants included in the study had no history of diabetes and had at least one hemoglobin A1c (HbA1c) test prior to their first birth. The study found that preconception prediabetes was associated with more than twice the likelihood of gestational diabetes at future first birth. Additionally, prediabetes during adolescence and young adulthood was linked to an 18 percent increased risk of hypertensive disorders during pregnancy, such as gestational hypertension and preeclampsia, as well as preterm delivery.

The study also identified that the optimal HbA1c threshold for predicting gestational diabetes in young people was slightly lower than the threshold used for adults (5.6 percent vs. 5.7 percent). According to the researchers, this finding suggests the need for updated clinical guidance on how to screen and counsel young people with elevated blood glucose levels.

“The lack of uniform preconception prediabetes treatment guidelines for adolescents may represent a missed opportunity to avert pregnancy-related complications,” said Katharine McCarthy, PhD, assistant professor of Population Health Science and Policy, and Obstetrics, Gynecology and Reproductive Science at the Icahn School of Medicine at Mount Sinai.

The research team plans to further investigate potential school policies and interventions that could help reduce cardiometabolic risks during adolescence and ultimately improve pregnancy and health outcomes across the lifespan. “Our results support expanded preconception hemoglobin A1c screening as a mechanism to intervene on excess cardiometabolic risk earlier in the life course,” the authors noted.

For integrative practitioners, these findings emphasize the importance of early screening and proactive health counseling for young patients, especially those at high risk for prediabetes. This approach could be vital in reducing the long-term impacts of prediabetes on maternal and neonatal health, underscoring the need for a comprehensive strategy that addresses metabolic health from adolescence through adulthood.