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

Title: Performance of early pregnancy HbA1c for predicting gestational diabetes mellitus and adverse pregnancy outcomes in obese European women
Authors: 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.; Snoek F. J.; Scharnagl H.; Galjaard S.; Kautzky-Willer A.; VAN Poppel M. N. M.
Contributors: 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.; Snoek, F. J.; Scharnagl, H.; Galjaard, S.; Kautzky-Willer, A.; Van Poppel, M. N. M.
Publisher Information: Elsevier Ireland Ltd
Publication Year: 2020
Collection: Padua Research Archive (IRIS - Università degli Studi di Padova)
Subject Terms: Diagnostic threshold; Gestational diabetes mellitu; Hemoglobin A; 1c; Odds Ratio; Pregnancy; Pregnancy outcome
Description: 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.
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/32828833; info:eu-repo/semantics/altIdentifier/wos/WOS:000598493500003; volume:168; journal:DIABETES RESEARCH AND CLINICAL PRACTICE; https://hdl.handle.net/11577/3355018
DOI: 10.1016/j.diabres.2020.108378
Availability: https://hdl.handle.net/11577/3355018; https://doi.org/10.1016/j.diabres.2020.108378
Rights: info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by-nc-nd/4.0/
Accession Number: edsbas.6D790D20
Database: BASE