Immature Granulocytes are Closely Associated with the Development of Maternal Gestational Diabetes Mellitus and Adverse Pregnancy Outcomes

Abstract

Background: Gestational diabetes mellitus (GDM) is defined as any degree of dysglycaemia that occurs for the first time or is first detected during pregnancy. GDM causes various complications for both the mother and fetus. Immature granulocytes (IGs) may enter the peripheral blood in response to infection, inflammation, or other stimuli. In this study, we delve into the role of IGs in the occurrence and development of GDM as well as their correlation with pregnancy outcomes. Purpose: This study aimed to investigate the risk factors for gestational diabetes mellitus (GDM) as well as the correlation between immature granulocytes (IGs) and maternal pregnancy outcome. Methods: This study was conducted between January 1, 2019 and December 31, 2019 at the Womens Hospital, School of Medicine, Zhejiang University. We collected maternal demographic data and clinical information on major adverse pregnancy outcomes from medical records. We implemented multiple logistic regression models to determine the association between maternal IGs and adverse pregnancy outcomes. Results: A total of 9558 pregnant women, including 7613 controls (those without GDM) and 1945 pregnant women diagnosed with GDM. We found that compared to those without GDM (control group), GDM patients exhibited a significantly higher percentage of immature granulocytes (1.22% ± 1.03% vs. 1.34% ± 1.26%, p < 0.01), and absolute immature granulocyte count (0.12 ± 0.13 × 10⁹/L vs. 0.14 ± 0.15 × 10⁹/L, p < 0.001). Furthermore, GDM patients manifested substantially higher rates of premature birth (6.96% vs. 10.13%, p < 0.001), macrosomia (4.39% vs. 5.55%, p < 0.05), and cesarean section (34.6% vs. 41.8%, p < 0.001). We found that after adjusting for potential confounding variables, IGs were found to be associated with a high risk for GDM (absolute value of IGs, adjusted odds ratio [aOR] = 2.265; percentage of IGs [aOR = 1.100]), preterm birth (absolute value of IGs, aOR = 5.325; percentage of IGs, aOR = 1.209), and macrosomia (absolute IG count, aOR = 1.503). Conclusions: Our study demonstrates an association between IGs and GDM. Furthermore, IGs can serve as a risk factor associated with preterm delivery and macrosomia.