Elevated Hba1C During First Trimester Linked With Adverse Pregnancy Outcome
Gestational diabetes (GDM) is a common pregnancy complication associated with adverse maternal and fetal outcomes including an increased risk for type 2 diabetes and cardiovascular disease later in life in mothers and an increased risk for macrosomia and obesity in offspring. However, a recent study suggests that elevated glycated haemoglobin (HbA1c) in the first trimester (HbA1c-FT) is...
Gestational diabetes (GDM) is a common pregnancy complication associated with adverse maternal and fetal outcomes including an increased risk for type 2 diabetes and cardiovascular disease later in life in mothers and an increased risk for macrosomia and obesity in offspring. However, a recent study suggests that elevated glycated haemoglobin (HbA1c) in the first trimester (HbA1c-FT) is linked with adverse pregnancy events in non-GDM Asian Indians. The updated study findings were published in the Journal of Diabetes and its Complications on April 13, 2022.
HbA1c analysis was endorsed as a screening test for unrecognised diabetes in both the general population and in early pregnancy. A few prior studies have examined if HbA1c measured in the first trimester is useful for the early prediction of GDM. However, its significance in non-GDM individuals is understudied. Therefore, Dr John Punnose and his team conducted a study to determine the association of HbA1c-FT with adverse events among pregnant Asian Indian women without GDM.
In this retrospective cohort study, the researchers included 1618 pregnant women who delivered at a single urban tertiary care centre and had HbA1c-FT estimation between January 2011 and September 2017. They used multivariable logistic regression models to assess the association between elevated HbA1c-FT and adverse events.
Key findings of the study:
- Upon analysis, the researchers found that at a cutoff of ≥37 mmol/mol (5.5%), HbA1c-FT was associated with preterm birth at <37 gestational weeks (adjusted odds ratio (OR) 2.10).
- They observed that there was a continuum of risk for primary caesarean delivery with higher HbA1c-FT levels (adjusted OR per 5-mmol/mol (0.5%) increase in HbA1c-FT for primary caesarean delivery: 1.27).
- Upon crude analysis, they found that gestational hypertension was associated with HbA1c-FT. However, not after adjustment for confounding factors.
- They reported that HbA1c-FT was not associated with other adverse events (macrosomia, large for gestational age babies, or other neonatal complications).
The authors concluded, "Even without GDM, the results suggest an association of HbA1c-FT with preterm birth and primary caesarian delivery among Asian Indian women."
They further highlighted, "Mechanism of HbA1c-FT association with adverse events in non-GDM women is unclear".
For further information:
Medical Dialogues Bureau consists of a team of passionate medical/scientific writers, led by doctors and healthcare researchers. Our team efforts to bring you updated and timely news about the important happenings of the medical and healthcare sector. Our editorial team can be reached at email@example.com.