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Rigshospitalet - a part of Copenhagen University Hospital
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Performance of early pregnancy HbA1c for predicting gestational diabetes mellitus and adverse pregnancy outcomes in obese European women

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Risk of diabetes among related and unrelated family members

    Research output: Contribution to journalJournal articleResearchpeer-review

  • 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
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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 languageEnglish
JournalDiabetes Research and Clinical Practice
Volume168
Pages (from-to)108378
ISSN0168-8227
DOIs
Publication statusPublished - Oct 2020

ID: 61350788