Performance of early pregnancy HbA1c for predicting gestational diabetes mellitus and adverse pregnancy outcomes in obese European women

Jincy Immanuel, David Simmons, Gernot Desoye, Rosa Corcoy, Juan M Adelantado, Roland Devlieger, Annunziata Lapolla, Maria G Dalfra, Alessandra Bertolotto, Jürgen Harreiter, Ewa Wender-Ozegowska, Agnieszka Zawiejska, Fidelma P Dunne, Peter Damm, Elisabeth R Mathiesen, Dorte M Jensen, Lise Lotte T Andersen, David J Hill, Judith G M Jelsma, Frank J SnoekHubert Scharnagl, Sander Galjaard, Alexandra Kautzky-Willer, Mireille N M VAN Poppel

    15 Citationer (Scopus)

    Abstract

    AIMS: To investigate the performance of early pregnancy HbA1c for predicting gestational diabetes mellitus (GDM) and adverse pregnancy outcomes in obese women.

    METHODS: Post hoc analysis using data from the Vitamin D And Lifestyle Intervention for GDM prevention trials conducted across 9 European countries (2012-2014). Pregnant women (BMI ≥ 29 kg/m2) underwent a baseline HbA1c and oral glucose tolerance tests at < 20 weeks, 24-28 weeks, and 35-37 weeks. Women with GDM were referred for treatment.

    RESULTS: Among the 869 women tested, the prevalence of GDM was 25.9% before 20 weeks, with a further 8.6% at 24-28 weeks. The areas under the curves for HbA1c at the two time points were 0.55 (0.50-0.59) and 0.54 (0.47-0.61), respectively. An early HbA1c ≥ 5.7% (39 mmol/mol) (N = 111) showed low sensitivity (18.2%) with 89.1% specificity for GDM before 20 weeks, at 24-28 weeks (sensitivity of 8.0% and specificity of 88.6% after excluding early GDM), and throughout gestation (sensitivity of 15.9% and specificity of 89.4%). The ≥ 5.7% (39 mmol/mol) threshold was significantly associated with concurrent GDM before 20 weeks (adjusted OR (aOR) 2.77(1.39-5.51)) and throughout gestation (aOR 1.72 (1.02-2.89)), but not adverse pregnancy outcomes.

    CONCLUSIONS: Early pregnancy HbA1c is of limited use for predicting either GDM or adverse outcomes in overweight/obese European women.

    OriginalsprogEngelsk
    Artikelnummer108378
    TidsskriftDiabetes Research and Clinical Practice
    Vol/bind168
    Sider (fra-til)108378
    ISSN0168-8227
    DOI
    StatusUdgivet - okt. 2020

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