Glycosylated Hemoglobin in Diabetic and Nondiabetic Pregnancies

Kf, McFarland; Ew, Catalano; Je, Keil; De, M.L.

doi:10.1097/00007611-198104000-00009

Cited by 5 publications

(3 citation statements)

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“…HbA1c values also decrease by 12-16 weeks of gestation, with a further decrease that plateaus by gestational weeks 20-24. HbA1c levels may start to rise again in the third trimester (33)(34)(35)(36). The findings of this study identify third trimester HbA1c level as a determinant of LGA in pregnancies affected with GDM.…”

Section: Discussionmentioning

confidence: 65%

Third trimester HbA1c and the association with large-for-gestational-age neonates in women with gestational diabetes

Fonseca¹,

Saraiva²,

Amado³

et al. 2021

Archives of Endocrinology and Metabolism

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Objective: To evaluate the association between HbA1c levels measured in the third trimester and the risk for large for gestational age (LGA) in neonates of mothers affected by gestational diabetes mellitus (GDM). Secondarily, we aimed to identify an ideal cut-off for increased risk of LGA amongst pregnant women with GDM. Materials and methods: Observational retrospective review of singleton pregnant women with GDM evaluated in a diabetes and pregnancy clinic of a tertiary and academic hospital. From January/2011 to December/2017, 1,085 pregnant women underwent evaluation due to GDM, of which 665 had an HbA1c test in the third trimester. A logistic regression model was performed to evaluate predictors of LGA. A receiver-operating-characteristic (ROC) curve was used to evaluate the predictive ability of third trimester HbA1c for LGA identification. Results: A total of 1,085 singleton pregnant women were evaluated during the study period, with a mean age of 32.9 ± 5.3 years. In the multivariate analysis, OGTT at 0 minutes (OR: 1.040; CI 95% 1.006-1.076, p = 0.022) and third trimester HbA1c (OR: 4.680; CI 95% 1.210-18.107, p = 0.025) were associated with LGA newborns. Using a ROC curve to evaluate the predictive ability of third trimester HbA1c for LGA identification, the optimal HbA1c cut-off point was 5.4% where the sensitivity was 77.4% and the specificity was 71.7% (AUC 0.782; p < 0.001). Conclusions: Few studies in the Mediterranean population have evaluated the role of HbA1c in predicting neonatal complications in women with GDM. A third trimester HbA1c > 5.4% was found to have good sensitivity and specificity for identifying the risk of LGA.

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Section: Discussionmentioning

confidence: 65%

Third trimester HbA1c and the association with large-for-gestational-age neonates in women with gestational diabetes

Fonseca¹,

Saraiva²,

Amado³

et al. 2021

Archives of Endocrinology and Metabolism

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“…McFarland et al also reported a decrease in HbA 1c from the first half of pregnancy to the third trimester. 49 …”

Section: Role Of Hba 1c In Screening For Gestationmentioning

confidence: 99%

“…OGTT is recommended at the first opportunity after conception for women having any of the high-risk factors for GDM listed in Table 2 . 49 …”

Section: Recommendationsmentioning

confidence: 99%

Updated guidelines on screening for gestational diabetes

Gupta

Kalra²,

Baruah³

et al. 2015

IJWH

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Gestational diabetes mellitus (GDM) is associated with an increased risk of complications for both mother and baby during pregnancy as well as in the postpartum period. Screening and identifying these high-risk women is important to improve short- and long-term maternal and fetal outcomes. However, there is a lack of international uniformity in the approach to the screening and diagnosis of GDM. The main purpose of this review is to provide an update on screening for GDM and overt diabetes during pregnancy, and discuss the controversies in this field. We take on debatable issues such as adoption of the new International association of diabetes and pregnancy study groups criteria instead of the Carpenter and Coustan criteria, one-step versus two-step screening, universal screening versus high-risk screening before 24 weeks of gestation for overt diabetes, and, finally, the role of HbA1c as a screening test of GDM. This discussion is followed by a review of recommendations by professional bodies. Certain clinical situations, in which a pragmatic approach is needed, are highlighted to provide a comprehensive overview of the subject.

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Gestational Diabetes Mellitus Screening and Diagnosis

Sert

Özgü-Erdinç

2020

Advances in Experimental Medicine and Biology

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Glycosylated Hemoglobin in Diabetic and Nondiabetic Pregnancies

Cited by 5 publications

References 0 publications

Third trimester HbA1c and the association with large-for-gestational-age neonates in women with gestational diabetes

Third trimester HbA1c and the association with large-for-gestational-age neonates in women with gestational diabetes

Updated guidelines on screening for gestational diabetes

Gestational Diabetes Mellitus Screening and Diagnosis

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