Elevated third-trimester haemoglobin A 1c predicts preterm delivery in type 1 diabetes

J Diabetes Complications. Sep-Oct 2008;22(5):297-302. doi: 10.1016/j.jdiacomp.2007.03.008. Epub 2008 Apr 16.

Abstract

The prevalence of preterm delivery is considerably elevated in women with type 1 diabetes. The aim of the study was to evaluate haemoglobin A(1c) (HbA(1c)) as a predictor of preterm delivery. Two hundred thirteen consecutive pregnant women with type 1 diabetes and normal urinary albumin excretion were included prospectively. HbA(1c) was analyzed at 10, 20 and 28 weeks of gestation. Seventy-one women (33%) delivered pre term and 142 at term. At 10 weeks of gestation, HbA(1c) was 7.3% (S.D. 1.0) vs. 6.9% (S.D. 0.9) (P<.01), at 20 weeks of gestation 6.6% (S.D. 0.7) vs. 6.1% (S.D. 0.7) (P<.001) and at 28 weeks of gestation 6.7% (S.D. 0.8) vs. 6.1% (S.D. 0.7) (P<.001). When comparing HbA(1c) at 10, 20 and 28 weeks of gestation, HbA(1c) at 28 weeks of gestation (P<.001) was the best predictor of preterm delivery. The adjusted odds ratio per 1% increment in HbA(1c) at 28 weeks of gestation was 2.8 (95% CI 1.7-4.4). HbA(1c) at 28 weeks of gestation was a clinical significant predictor of preterm delivery in type 1 diabetes.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Diabetes Mellitus, Type 1 / blood*
  • Female
  • Gestational Age
  • Glycated Hemoglobin A / analysis*
  • Humans
  • Hypoglycemia / blood
  • Hypoglycemia / complications
  • Infant, Newborn
  • Pregnancy
  • Pregnancy Trimester, Third / blood*
  • Premature Birth / blood
  • Premature Birth / diagnosis*
  • Premature Birth / etiology
  • Prognosis
  • Risk Factors
  • Up-Regulation

Substances

  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human