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Association Between Maternal Normal Range HbA1c Values and Adverse Birth Outcomes.

Jianing Bi1, Cunwei Ji2, Yuntao Wu2

  • 1Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

The Journal of Clinical Endocrinology and Metabolism
|March 14, 2020
PubMed
Summary

Higher normal glycated hemoglobin A1c (HbA1c) in pregnancy increases risks for preterm birth, macrosomia, and large for gestational age (LGA). Managing HbA1c may prevent adverse birth outcomes.

Keywords:
adverse birth outcomesnormal range HbA1cpregnant women

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Area of Science:

  • Obstetrics and Gynecology
  • Endocrinology
  • Maternal-Fetal Medicine

Background:

  • Elevated blood glucose during pregnancy is linked to adverse birth outcomes.
  • Limited evidence exists on the association between HbA1c within the normal range and adverse birth outcomes.

Purpose of the Study:

  • To investigate the association between HbA1c levels within the normal range and the risk of adverse birth outcomes in pregnant women.

Main Methods:

  • Analysis of data from 5658 pregnant women with normal gestational HbA1c (September 2014–March 2018).
  • Utilized multivariate logistic regression to assess the association between maternal HbA1c and adverse birth outcomes (preterm birth, macrosomia, LGA).

Main Results:

  • Increased maternal HbA1c within the normal range was positively associated with higher risks of preterm birth (OR 1.58), macrosomia (OR 1.70), and LGA (OR 1.38).
  • The association between gestational HbA1c and preterm birth was more pronounced in women with a prepregnancy BMI ≤ 24 kg/m2.

Conclusions:

  • Higher HbA1c levels within the normal range during pregnancy are an independent risk factor for preterm birth, macrosomia, and LGA.
  • Interventions aimed at reducing HbA1c may be beneficial in preventing adverse birth outcomes.