First-trimester glycosylated hemoglobin (HbA1c) and maternal characteristics in the prediction of gestational diabetes: An observational cohort study.

Amylidi-Mohr, Sofia; Lang, Cheryl; Mosimann, Beatrice; Fiedler, Georg M; Stettler, Christoph; Surbek, Daniel; Raio, Luigi (2023). First-trimester glycosylated hemoglobin (HbA1c) and maternal characteristics in the prediction of gestational diabetes: An observational cohort study. Acta obstetricia et gynecologica Scandinavica, 102(3), pp. 294-300. Wiley-Blackwell 10.1111/aogs.14495

[img]
Preview
Text
Acta_Obstet_Gynecol_Scand_-_2022_-_Amylidi_Mohr_-_First_trimester_glycosylated_hemoglobin_HbA1c_and_maternal.pdf - Published Version
Available under License Creative Commons: Attribution-Noncommercial (CC-BY-NC).

Download (949kB) | Preview

INTRODUCTION

This study aimed to investigate the extent to which gestational diabetes mellitus (GDM) can be predicted in the first trimester by combining a marker of growing interest, glycosylated hemoglobin A1c (HbA1c), and maternal characteristics.

MATERIAL AND METHODS

This observational study was conducted in the outpatient obstetric department of our institution. The values of HbA1c and venous random plasma glucose were prospectively assessed in the first trimester of pregnancy. We determined maternal characteristics that were independent predictors from the regression analysis and calculated areas under the receiver-operating curves by combining the maternal age, body mass index, previous history of GDM, and first-degree family history for diabetes mellitus. Moreover we investigated the predictive capability of HbA1c to exclude GDM. Patients with a first-trimester HbA1c level of 6.5% (48 mmol/mol) or more were excluded. The study was registered at ClinicalTrials.gov ID: NCT02139254.

RESULTS

We included 785 cases with complete dataset. The prevalence of GDM was 14.7% (115/785). Those who developed GDM had significantly higher HbA1c and random plasma glucose values (p < 0.0001 and p = 0.0002, respectively). In addition, they had a higher body mass index, were more likely to have a history of GDM and/or a first-degree family history of diabetes. When these maternal characteristics were combined with the first-trimester HbA1c and random plasma glucose the combined area under the receiver operating characteristics curve was 0.76 (95% CI 0.70-0.81).

CONCLUSIONS

Our results indicate that HbA1c and random plasma glucose values combined with age, body mass index, and personal and family history, allow the identification of women in the first trimester who are at increased risk of developing GDM.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Institute of Clinical Chemistry
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Endocrinology, Diabetology and Clinical Nutrition
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology

UniBE Contributor:

Amylidi-Mohr, Sofia, Mosimann, Beatrice, Fiedler, Georg Martin, Stettler, Christoph, Surbek, Daniel, Raio, Luigi

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0001-6349

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Pubmed Import

Date Deposited:

19 Dec 2022 09:33

Last Modified:

25 Feb 2023 00:14

Publisher DOI:

10.1111/aogs.14495

PubMed ID:

36524557

Uncontrolled Keywords:

gestational diabetes glycosylated hemoglobin A1c pregnancy complications screening method

BORIS DOI:

10.48350/176021

URI:

https://boris.unibe.ch/id/eprint/176021

Actions (login required)

Edit item Edit item
Provide Feedback