Association of Normal-Range Hemoglobin A1c Value During Midpregnancy with Adverse Birth Outcomes

Zhang, Lihua; Zhai, Ruixia; Huo, Zhiyu; Wei, Zhenyan; Zhang, Ziheng; Wei, Ruirui; Man, Dongmei

doi:10.2147/ijgm.s313952

Cited by 3 publications

(1 citation statement)

References 29 publications

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“…This is clinically significant when defining the goal for HbA1c in diabetic individuals. During the second trimester, HbA1c levels above the normal range (5.1 − 6.4%, or 32–45 mmol/mol) were associated with an increased risk of adverse pregnancy complications, such as large for gestation age, macrosomia, preterm birth, and preeclampsia [ 26 , 27 ]. Furthermore, recent research examining continuous glucose monitoring in pregnant women who do not have GDM according to the IADPSG criteria has revealed irregular glycemic fluctuations in these pregnancies as well [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Trimester-specific reference intervals for hemoglobin A1c in non-diabetic pregnancy in a Chinese population

Deng,

Cheng,

Liao

et al. 2023

BMC Pregnancy Childbirth

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Background Physiological glycated hemoglobin (HbA1c) values in each trimester are not well defined. This study aimed to determine trimester-specific reference intervals for HbA1c levels in non-diabetic pregnant women in China. Methods In this cross-sectional study, 5,042 Chinese pregnant women from 6 to 41 weeks of gestation were screened. An inclusion of 4,134 non-diabetic women was made to determine the reference intervals, they were divided into three trimesters: trimester 1 (T1), 6 weeks to 13 weeks + 6 days, trimester 2 (T2), 14 weeks to 27 weeks + 6 days, and trimester 3 (T3), 28 weeks to 41 weeks + 6 days. A total of 4,134 women (T1 n = 760, T2 n = 1,953, and T3 n = 1,421) provided blood samples which were analyzed for HbA1c concentrations. HbA1c was measured using high-performance liquid chromatography. The median and percentile (2.5th to 97.5th) for the HbA1c reference intervals were calculated for each trimester. Results In total, 8,732 HbA1c measurements were taken. Reference intervals for HbA1c expressed as median and percentile (2.5th to 97.5th) for each trimester were: T1: 4.7 (4.0–5.5%), T2: 4.5 (3.9–5.3%), and T3: 4.8 (4.1–5.7%) respectively. The HbA1c levels were significantly lower in the second trimester compared to those in the first trimester (p < 0.0001), and higher in the third trimester compared to the second trimester (p < 0.0001). Conclusions The reference intervals for HbA1c levels were 3.9–5.7% with upper limits of 5.5% in the first trimester, 5.3% in the second trimester, and 5.7% in the third trimester. These findings highlight the importance of considering trimester-specific reference intervals for HbA1c in non-diabetic pregnant women to promote maternal and fetal health.

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Section: Discussionmentioning

confidence: 99%

Trimester-specific reference intervals for hemoglobin A1c in non-diabetic pregnancy in a Chinese population

Deng,

Cheng,

Liao

et al. 2023

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

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Association between maternal gestation weight gain and preterm birth according to pre-pregnancy body mass index and HbA1c

Zhang,

Yin,

et al. 2024

Journal of Obstetrics and Gynaecology

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Association between mid-pregnancy HbA1c values and anemia in women without gestational diabetes

Zhai

Wei

et al. 2023

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Background: Previous studies have examined the association between glycated hemoglobin (HbA1c) and hemoglobin (Hb) levels among non-diabetic people. However, there are no reports relating to the correlation between HbA1c values and anemia in women without gestational diabetes. We, therefore, examined whether there is an association between mid-pregnancy HbA1c values and anemia in women without gestational diabetes. Methods: This retrospective cohort study was conducted at the Affiliated Hospital of Jining Medical University, Jining, China, from January to December 2019. Cases of single pregnancies in women above 18 years old, with recorded HbA1c values at 14-27+6 weeks of gestation, were examined. Women with pregestational diabetes mellitus (GDM) or the development of GDM were excluded. The association between variations in mid-pregnancy HbA1c values and anemia was examined. Results: Among 8553 women without gestational diabetes, univariate analysis results demonstrated a significant positive relationship between (P<.001) mid-pregnancy HbA1c values and anemia, after adjusting for confounding factors. Multivariate piecewise linear regression showed that anemia decreased when HbA1c values were <4.6% (OR 0.40; 95% CI, 0.15-1.04; P=.592) and increased when HbA1c values were was >4.6 % (OR 3.83; 95% CI, 2.95-4.98; P<.0001). Conclusion: This study showed a nonlinear relationship between mid-pregnancy HbA1c values and anemia in women without gestational diabetes. When the HbA1c values increased to the inflection point, they were positively correlated with anemia. Further studies are needed to explore this relationship and the mechanisms involved in the future.

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Association of Normal-Range Hemoglobin A1c Value During Midpregnancy with Adverse Birth Outcomes

Cited by 3 publications

References 29 publications

Trimester-specific reference intervals for hemoglobin A1c in non-diabetic pregnancy in a Chinese population

Trimester-specific reference intervals for hemoglobin A1c in non-diabetic pregnancy in a Chinese population

Association between maternal gestation weight gain and preterm birth according to pre-pregnancy body mass index and HbA1c

Association between mid-pregnancy HbA1c values and anemia in women without gestational diabetes

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