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Acta Obstet Gynecol Scand. 2016 Jan;95(1):93-7. doi: 10.1111/aogs.12784. Epub 2015 Oct 26.

First-trimester glycosylated hemoglobin in women at high risk for gestational diabetes.

Author information

1
Department for Gynecology and Obstetrics, Inselspital, University Hospital of Bern and University of Bern, Bern, Switzerland.
2
Department for Endocrinology and Diabetes, Inselspital, University Hospital of Bern and University of Bern, Bern, Switzerland.
3
Center of Laboratory Medicine, University Institute of Clinical Chemistry, Inselspital, University Hospital of Bern and University of Bern, Bern, Switzerland.

Abstract

INTRODUCTION:

Our aim was to investigate the prognostic value of first-trimester glycosylated hemoglobin (HbA1c) in pregnant women with risk factors for developing gestational diabetes mellitus (GDM).

MATERIAL AND METHODS:

This is an observational retrospective cohort study conducted at the Department of Obstetrics and Gynecology, University Hospital Bern, Switzerland. We included pregnant women at high risk for GDM (n = 208), who had an HbA1c measurement in the first trimester. We compared HbA1c values of women who later developed GDM with those who did not develop GDM. Diagnosis of GDM was made on the basis of a 75-g oral glucose tolerance test performed between 24 and 28 weeks of gestation. We further examined the prevalence of GDM in relation to the first-trimester HbA1c value.

RESULTS:

The prevalence of GDM in our high-risk group was 14.7%. Women who developed GDM had significantly higher first-trimester HbA1c values [5.43 ± 0.31% (36 ± 3 mmol/mol) vs. 5.23 ± 0.28% (34 ± 3 mmol/mol); p = 0.0026]. Moreover, all pregnant women with HbA1c ≥ 6.0% (42 mmol/mol) developed GDM, whereas those with < 4.5% (26 mmol/mol) did not.

CONCLUSIONS:

Women at risk for GDM have higher first-trimester HbA1c levels and values ≥ 6.0% (42 mmol/mol) are predictive of GDM. This information may be useful for counseling these women and providing appropriate advice on diet and lifestyle modification early in pregnancy.

KEYWORDS:

Gestational diabetes mellitus; HbA1c; glycosylated haemoglobin; high-risk pregnancy; oral glucose tolerance test

PMID:
26400192
DOI:
10.1111/aogs.12784
[Indexed for MEDLINE]

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