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Recording available 2/16-5/2
Recording available 2/16-5/2
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Abstract Award
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Poster Session 1

Category: Diabetes

Poster Session 1

(1080) Can Early Pregnancy Glucose Predict Gestational Diabetes and Large-for-Gestational Age Neonates?

Wednesday, February 11, 2026
10:30 AM - 12:00 PM  

    Coauthor(s)

  • Erika F. Werner, MD, MS (she/her/hers)

    President, Physician Organization; Professor, Maternal-Fetal Medicine
    Tufts University School of Medicine
    Boston, Massachusetts, United States

    • Submitting Author and Presenting Author(s)

  • Denise Scholtens, PhD

    Professor and Division Chief
    Northwestern University Feinberg School of Medicine
    Chicago, Illinois, United States

    • Coauthor(s)

  • AK

    Alan Kuang, MS

    Senior Biostatistician
    Northwestern University
    Chicago, Illinois, United States

  • PC

    Patrick M. Catalano, MD

    Reproductive Endocrinology
    MGH REU
    Boston, Massachusetts, United States

  • Francesca Facco, MD

    Associate Professor, Maternal-Fetal Medicine
    UPMC
    UPMC, Pennsylvania, United States

  • MF

    Maisa Feghali, MD

    Associate Professor
    Magee Women's Research Institute, University of Pittsburgh
    Pittsburgh, Pennsylvania, United States

  • WG

    William A. Grobman, MBA, MD

    Professor
    Warren Alpert Medical School of Brown University
    Providence, Rhode Island, United States

  • EL

    Erin S. LeBlanc, MD, MPH

    Kaiser Permanente Center for Health Research
    Portland, Oregon, United States

  • AM

    Audrey Merriam, MD, MS

    Yale School of Medicine
    Yale School of Medicine, Connecticut, United States

  • MM

    Mirella Mourad, MD

    Assistant Professor
    Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center
    New York, New York, United States

  • CO

    Caryn E.S. Oshiro, MS, PhD

    Investigator
    Kaiser Permanente Hawaii, Center for Integrated Health Care Research
    Honolulu, Hawaii, United States

  • Camille E. Powe, MD (she/her/hers)

    Associate Professor
    Massachusetts General Hospital
    Boston, Massachusetts, United States

  • UR

    Uma M. Reddy, MD, MPH

    Professor
    Columbia University Irving Medical Center
    New York, New York, United States

  • Dwight J. Rouse, MD, MSPH

    Professor
    Women & Infants Hospital of Rhode Island / Warren Alpert Medical School of Brown University
    Providence, Rhode Island, United States

  • JS

    Jennifer Sherr, MD, PhD

    Yale School of Medicine
    New Haven, Connecticut, United States

  • AS

    Alexandra C. Spadola, MD

    Clinical Associate Professor, Maternal Fetal Medicine
    Tufts University School of Medicine
    Boston, Massachusetts, United States

  • KV

    Kimberly K. Vesco, BA, MD, MPH

    Distinguished Investigator
    Kaiser Permanente Center for Health Research
    Portland, Oregon, United States

  • Lynn M. Yee, MD, MPH (she/her/hers)

    Associate Professor
    Northwestern University Feinberg School of Medicine
    Chicago, Illinois, United States

  • Noelia Zork, MD

    Associate Professor
    Columbia University Irving Medical Center
    New York, New York, United States

  • WL

    William L. Lowe, MD

    Northwestern University
    Northwestern University, Illinois, United States

Objective:
To evaluate whether data from early pregnancy oral glucose tolerance testing (OGTT) or continuous glucose monitoring (CGM) improves prediction of gestational diabetes (GDM) or large for gestational age (LGA) birthweight compared to clinical risk factors alone.

Study Design:
In a prospective observational study at 9 US centers, adults with a singleton pregnancy and no pre-existing diabetes underwent 75-g OGTT and CGM placement at 10-14 wks’ gestation. Co-primary outcomes were GDM at 24-28 wks’ gestation (Carpenter-Coustan criteria) and LGA (birthweight > 90%). We evaluated a wide range of criteria for the 10-14 wk OGTT and CGM to develop optimal models for GDM and LGA prediction in combination with clinical factors (age, BMI, history of GDM or macrosomia). Glycemic criteria were selected to maximize model area under the ROC curve (AUC) in a training dataset from 4 centers, with data from 5 centers reserved for validation. To evaluate models incorporating OGTT or CGM + clinical factors v. clinical factors alone for identifying high-risk individuals who may benefit from early intervention, we compared PPV at a prespecified NPV (> 1- prevalence/2), with prevalence set at 8.3% for GDM and 10% for LGA based on national data.

Results:

Of 2178 participants enrolled from 2021-2024, 90.3% completed OGTTs at 24-28 wks and 95.9% had live births; 15.4% had GDM and 11.3% had LGA infants. ROC curves for optimal OGTT, CGM, and clinical factor models are shown (Figure). For GDM, both glycemic models (10-14 wk OGTT or CGM + clinical factors) improved PPV compared to clinical factors alone: at prevalence=8.3% and NPV=> 96%, PPV was 12.2% for clinical factors, 26.5% for OGTT, and 22.5% for CGM (Table).  For LGA, neither glycemic model improved PPV compared to clinical factors alone. Validation confirmed findings. 

Conclusion:

Although adding data from 10-14 wk OGTT or CGM to clinical factors improved GDM prediction, the PPV was modest and their addition had no value for LGA prediction.  These results do not support using early pregnancy OGTT or CGM to identify individuals at high risk for subsequent GDM or LGA.