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 Snoek; Hubert Scharnagl; Sander Galjaard; Alexandra Kautzky-Willer; Mireille N M VAN Poppel

doi:10.1016/j.diabres.2020.108378

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

26 Citations (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.

Original language	English
Article number	108378
Journal	Diabetes Research and Clinical Practice
Volume	168
Pages (from-to)	108378
ISSN	0168-8227
DOIs	https://doi.org/10.1016/j.diabres.2020.108378
Publication status	Published - Oct 2020

Keywords

Diagnostic threshold
Gestational diabetes mellitus
Hemoglobin A
Odds Ratio
Pregnancy
Pregnancy outcome

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10.1016/j.diabres.2020.108378

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Immanuel, J., Simmons, D., Desoye, G., Corcoy, R., Adelantado, J. M., Devlieger, R., Lapolla, A., Dalfra, M. G., Bertolotto, A., Harreiter, J., Wender-Ozegowska, E., Zawiejska, A., Dunne, F. P., Damm, P., Mathiesen, E. R., Jensen, D. M., Andersen, L. L. T., Hill, D. J., Jelsma, J. G. M., ... VAN Poppel, M. N. M. (2020). Performance of early pregnancy HbA1c for predicting gestational diabetes mellitus and adverse pregnancy outcomes in obese European women. Diabetes Research and Clinical Practice, 168, 108378. Article 108378. https://doi.org/10.1016/j.diabres.2020.108378

Immanuel, J, Simmons, D, Desoye, G, Corcoy, R, Adelantado, JM, Devlieger, R, Lapolla, A, Dalfra, MG, Bertolotto, A, Harreiter, J, Wender-Ozegowska, E, Zawiejska, A, Dunne, FP, Damm, P , Mathiesen, ER, Jensen, DM, Andersen, LLT, Hill, DJ, Jelsma, JGM, Snoek, FJ, Scharnagl, H, Galjaard, S, Kautzky-Willer, A & VAN Poppel, MNM 2020, 'Performance of early pregnancy HbA1c for predicting gestational diabetes mellitus and adverse pregnancy outcomes in obese European women', Diabetes Research and Clinical Practice, vol. 168, 108378, pp. 108378. https://doi.org/10.1016/j.diabres.2020.108378

@article{518043e92a7a47c8ad2a1974bc7da576,

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

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.",

keywords = "Diagnostic threshold, Gestational diabetes mellitus, Hemoglobin A, Odds Ratio, Pregnancy, Pregnancy outcome",

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

note = "Copyright {\textcopyright} 2020. Published by Elsevier B.V.",

year = "2020",

month = oct,

doi = "10.1016/j.diabres.2020.108378",

language = "English",

volume = "168",

pages = "108378",

journal = "Diabetes Research and Clinical Practice",

issn = "0168-8227",

publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Performance of early pregnancy HbA1c for predicting gestational diabetes mellitus and adverse pregnancy outcomes in obese European women

AU - Immanuel, Jincy

AU - Simmons, David

AU - Desoye, Gernot

AU - Corcoy, Rosa

AU - Adelantado, Juan M

AU - Devlieger, Roland

AU - Lapolla, Annunziata

AU - Dalfra, Maria G

AU - Bertolotto, Alessandra

AU - Harreiter, Jürgen

AU - Wender-Ozegowska, Ewa

AU - Zawiejska, Agnieszka

AU - Dunne, Fidelma P

AU - Damm, Peter

AU - Mathiesen, Elisabeth R

AU - Jensen, Dorte M

AU - Andersen, Lise Lotte T

AU - Hill, David J

AU - Jelsma, Judith G M

AU - Snoek, Frank J

AU - Scharnagl, Hubert

AU - Galjaard, Sander

AU - Kautzky-Willer, Alexandra

AU - VAN Poppel, Mireille N M

PY - 2020/10

Y1 - 2020/10

N2 - 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.

AB - 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.

KW - Diagnostic threshold

KW - Gestational diabetes mellitus

KW - Hemoglobin A

KW - Odds Ratio

KW - Pregnancy

KW - Pregnancy outcome

UR - https://www.scopus.com/pages/publications/85090030724

U2 - 10.1016/j.diabres.2020.108378

DO - 10.1016/j.diabres.2020.108378

M3 - Journal article

C2 - 32828833

SN - 0168-8227

VL - 168

SP - 108378

JO - Diabetes Research and Clinical Practice

JF - Diabetes Research and Clinical Practice

M1 - 108378

ER -

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

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Keywords

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