First‐trimester glycosylated hemoglobin (HbA1c) and maternal characteristics in the prediction of gestational diabetes: An observational cohort study
Abstract Introduction This study aimed to investigate the extent to which gestational diabetes mellitus (GDM) can be predicted in the first trimester by combining a marker of growing interest, glycosylated hemoglobin A1c (HbA1c), and maternal characteristics. Material and methods This observational...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-03-01
|
| Series: | Acta Obstetricia et Gynecologica Scandinavica |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/aogs.14495 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850212005011521536 |
|---|---|
| author | Sofia Amylidi‐Mohr Cheryl Lang Beatrice Mosimann Georg M. Fiedler Christoph Stettler Daniel Surbek Luigi Raio |
| author_facet | Sofia Amylidi‐Mohr Cheryl Lang Beatrice Mosimann Georg M. Fiedler Christoph Stettler Daniel Surbek Luigi Raio |
| author_sort | Sofia Amylidi‐Mohr |
| collection | DOAJ |
| description | Abstract Introduction This study aimed to investigate the extent to which gestational diabetes mellitus (GDM) can be predicted in the first trimester by combining a marker of growing interest, glycosylated hemoglobin A1c (HbA1c), and maternal characteristics. Material and methods This observational study was conducted in the outpatient obstetric department of our institution. The values of HbA1c and venous random plasma glucose were prospectively assessed in the first trimester of pregnancy. We determined maternal characteristics that were independent predictors from the regression analysis and calculated areas under the receiver‐operating curves by combining the maternal age, body mass index, previous history of GDM, and first‐degree family history for diabetes mellitus. Moreover we investigated the predictive capability of HbA1c to exclude GDM. Patients with a first‐trimester HbA1c level of 6.5% (48 mmol/mol) or more were excluded. The study was registered at ClinicalTrials.gov ID: NCT02139254. Results We included 785 cases with complete dataset. The prevalence of GDM was 14.7% (115/785). Those who developed GDM had significantly higher HbA1c and random plasma glucose values (p < 0.0001 and p = 0.0002, respectively). In addition, they had a higher body mass index, were more likely to have a history of GDM and/or a first‐degree family history of diabetes. When these maternal characteristics were combined with the first‐trimester HbA1c and random plasma glucose the combined area under the receiver operating characteristics curve was 0.76 (95% CI 0.70–0.81). Conclusions Our results indicate that HbA1c and random plasma glucose values combined with age, body mass index, and personal and family history, allow the identification of women in the first trimester who are at increased risk of developing GDM. |
| format | Article |
| id | doaj-art-c8c6f528e2804404a1464a2b88bcfe0c |
| institution | OA Journals |
| issn | 0001-6349 1600-0412 |
| language | English |
| publishDate | 2023-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Acta Obstetricia et Gynecologica Scandinavica |
| spelling | doaj-art-c8c6f528e2804404a1464a2b88bcfe0c2025-08-20T02:09:25ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122023-03-01102329430010.1111/aogs.14495First‐trimester glycosylated hemoglobin (HbA1c) and maternal characteristics in the prediction of gestational diabetes: An observational cohort studySofia Amylidi‐Mohr0Cheryl Lang1Beatrice Mosimann2Georg M. Fiedler3Christoph Stettler4Daniel Surbek5Luigi Raio6Department of Gynecology and Obstetrics University Institute of Clinical Chemistry, University of Bern Bern SwitzerlandDepartment of Gynecology and Obstetrics University Institute of Clinical Chemistry, University of Bern Bern SwitzerlandDepartment of Gynecology and Obstetrics University Institute of Clinical Chemistry, University of Bern Bern SwitzerlandLaboratory of Medicine University Institute of Clinical Chemistry, University of Bern Bern SwitzerlandDepartment of Diabetology and Endocrinology University Hospital Inselspital Bern, University of Bern Bern SwitzerlandDepartment of Gynecology and Obstetrics University Institute of Clinical Chemistry, University of Bern Bern SwitzerlandDepartment of Gynecology and Obstetrics University Institute of Clinical Chemistry, University of Bern Bern SwitzerlandAbstract Introduction This study aimed to investigate the extent to which gestational diabetes mellitus (GDM) can be predicted in the first trimester by combining a marker of growing interest, glycosylated hemoglobin A1c (HbA1c), and maternal characteristics. Material and methods This observational study was conducted in the outpatient obstetric department of our institution. The values of HbA1c and venous random plasma glucose were prospectively assessed in the first trimester of pregnancy. We determined maternal characteristics that were independent predictors from the regression analysis and calculated areas under the receiver‐operating curves by combining the maternal age, body mass index, previous history of GDM, and first‐degree family history for diabetes mellitus. Moreover we investigated the predictive capability of HbA1c to exclude GDM. Patients with a first‐trimester HbA1c level of 6.5% (48 mmol/mol) or more were excluded. The study was registered at ClinicalTrials.gov ID: NCT02139254. Results We included 785 cases with complete dataset. The prevalence of GDM was 14.7% (115/785). Those who developed GDM had significantly higher HbA1c and random plasma glucose values (p < 0.0001 and p = 0.0002, respectively). In addition, they had a higher body mass index, were more likely to have a history of GDM and/or a first‐degree family history of diabetes. When these maternal characteristics were combined with the first‐trimester HbA1c and random plasma glucose the combined area under the receiver operating characteristics curve was 0.76 (95% CI 0.70–0.81). Conclusions Our results indicate that HbA1c and random plasma glucose values combined with age, body mass index, and personal and family history, allow the identification of women in the first trimester who are at increased risk of developing GDM.https://doi.org/10.1111/aogs.14495gestational diabetesglycosylated hemoglobin A1cpregnancy complicationsscreening method |
| spellingShingle | Sofia Amylidi‐Mohr Cheryl Lang Beatrice Mosimann Georg M. Fiedler Christoph Stettler Daniel Surbek Luigi Raio First‐trimester glycosylated hemoglobin (HbA1c) and maternal characteristics in the prediction of gestational diabetes: An observational cohort study Acta Obstetricia et Gynecologica Scandinavica gestational diabetes glycosylated hemoglobin A1c pregnancy complications screening method |
| title | First‐trimester glycosylated hemoglobin (HbA1c) and maternal characteristics in the prediction of gestational diabetes: An observational cohort study |
| title_full | First‐trimester glycosylated hemoglobin (HbA1c) and maternal characteristics in the prediction of gestational diabetes: An observational cohort study |
| title_fullStr | First‐trimester glycosylated hemoglobin (HbA1c) and maternal characteristics in the prediction of gestational diabetes: An observational cohort study |
| title_full_unstemmed | First‐trimester glycosylated hemoglobin (HbA1c) and maternal characteristics in the prediction of gestational diabetes: An observational cohort study |
| title_short | First‐trimester glycosylated hemoglobin (HbA1c) and maternal characteristics in the prediction of gestational diabetes: An observational cohort study |
| title_sort | first trimester glycosylated hemoglobin hba1c and maternal characteristics in the prediction of gestational diabetes an observational cohort study |
| topic | gestational diabetes glycosylated hemoglobin A1c pregnancy complications screening method |
| url | https://doi.org/10.1111/aogs.14495 |
| work_keys_str_mv | AT sofiaamylidimohr firsttrimesterglycosylatedhemoglobinhba1candmaternalcharacteristicsinthepredictionofgestationaldiabetesanobservationalcohortstudy AT cheryllang firsttrimesterglycosylatedhemoglobinhba1candmaternalcharacteristicsinthepredictionofgestationaldiabetesanobservationalcohortstudy AT beatricemosimann firsttrimesterglycosylatedhemoglobinhba1candmaternalcharacteristicsinthepredictionofgestationaldiabetesanobservationalcohortstudy AT georgmfiedler firsttrimesterglycosylatedhemoglobinhba1candmaternalcharacteristicsinthepredictionofgestationaldiabetesanobservationalcohortstudy AT christophstettler firsttrimesterglycosylatedhemoglobinhba1candmaternalcharacteristicsinthepredictionofgestationaldiabetesanobservationalcohortstudy AT danielsurbek firsttrimesterglycosylatedhemoglobinhba1candmaternalcharacteristicsinthepredictionofgestationaldiabetesanobservationalcohortstudy AT luigiraio firsttrimesterglycosylatedhemoglobinhba1candmaternalcharacteristicsinthepredictionofgestationaldiabetesanobservationalcohortstudy |