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Elevated third-trimester haemoglobin A 1c predicts preterm delivery in type 1 diabetes
Pia Ekbom1, Peter Damm, Bo Feldt-Rasmussen
1Endocrine Clinic, The National University Hospital, Rigshospitalet, Copenhagen, Denmark.
Journal of Diabetes and Its Complications
|April 17, 2008
Summary
High hemoglobin A1c levels in pregnant women with type 1 diabetes predict preterm delivery. Specifically, HbA1c at 28 weeks of gestation is the strongest indicator of early birth risk.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Perinatology
Background:
- Preterm delivery is a significant concern in pregnancies complicated by type 1 diabetes.
- Effective prediction of preterm birth is crucial for improved maternal and neonatal outcomes.
Purpose of the Study:
- To investigate the predictive value of hemoglobin A1c (HbA1c) for preterm delivery in women with type 1 diabetes.
- To determine the optimal gestational timing for HbA1c measurement as a predictor.
Main Methods:
- Prospective cohort study including 213 pregnant women with type 1 diabetes and normal urinary albumin excretion.
- HbA1c levels were measured at 10, 20, and 28 weeks of gestation.
- Statistical analysis compared HbA1c values between preterm and term delivery groups.
Main Results:
- A higher prevalence of preterm delivery (33%) was observed.
- Elevated HbA1c levels were consistently found at all measured time points in women delivering preterm compared to those delivering at term.
- HbA1c at 28 weeks of gestation demonstrated the strongest predictive power for preterm delivery (adjusted OR per 1% increment: 2.8).
Conclusions:
- Hemoglobin A1c at 28 weeks of gestation is a clinically significant predictor of preterm delivery in women with type 1 diabetes.
- Monitoring HbA1c in late pregnancy can aid in identifying high-risk pregnancies for preterm birth.
- These findings support closer glycemic management in the third trimester for type 1 diabetic pregnancies.
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