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.

中文翻译：

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新加坡孕前队列研究中的血浆血糖测量和受孕能力

目的 研究试图怀孕的妇女的血浆血糖与受孕能力之间的关系，以怀孕时间来衡量。设计基于人群的前瞻性孕前研究。设置医院。患者 18-45 岁的亚洲早孕女性，在研究开始时尝试受孕≤12 个周期。干预（S） 无。主要结果测量（S） 我们确定了在月经周期血糖评估后一年内怀孕的时间。我们使用离散时间比例风险模型估计了生育力比 (FR) 和 95% 置信区间，调整了年龄、种族、教育程度、体重指数和周期规律，并考虑了左截断和右删失。结果 我们研究了来自新加坡长期母婴结果前瞻性队列的孕前研究的 766 名女性的人口样本。与血糖正常的女性相比，血糖异常（前驱糖尿病和糖尿病，由美国糖尿病协会定义）女性的 FR 较低（0.56）。与各自的最低五分之一相比，空腹血糖最高五分之一（≥5.1 mmol/L）的女性的 FR 为 0.60，而负荷后 2 小时葡萄糖最高五分之一（≥6.9 mmol/L）的女性的 FR 为0.66。总体而言，FRs 在空腹和 2 小时血糖范围内普遍下降。糖化血红蛋白与生殖能力无关。结论(S) 增加孕前血浆葡萄糖与降低受孕能力有关，即使在葡萄糖浓度的正常范围内也是如此。