Glycosylated hemoglobin as predictor of adverse fetal outcome in type 1 diabetic pregnancies

Acta Diabetol. 1997 Oct;34(3):217-22. doi: 10.1007/s005920050077.

Abstract

The study aimed to determine whether a consistent dose-response association can be demonstrated, after adjustment for maternal age and White classification, between glycosylated hemoglobin (HbA1c) values before conception and in the first trimester of pregnancy of insulin-dependent diabetic mothers and adverse fetal outcome (abortions and major malformations). This is a historical follow-up study based on medical records in a geographically defined catchment area. The study comprised 60 pregnancies with HbA1c determinations before pregnancy and 161 with HbA1c in the first trimester in women with type 1 diabetes admitted between 1980 and 1992. Relative risk calculations indicated a highly significant and consistent correlation between HbA1c values above 6.6% and adverse fetal outcome after adjustment for differences in maternal age and White classification. Our data support a clinically significant and consistent relationship between adverse fetal outcome and HbA1c in the first trimester of pregnancy of type 1 mothers, without any indication of a cut-off level below which further improvement in HbA1c was of minor importance.

Publication types

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

MeSH terms

  • Abortion, Spontaneous / epidemiology
  • Abortion, Spontaneous / etiology
  • Adult
  • Age Factors
  • Congenital Abnormalities / epidemiology
  • Congenital Abnormalities / etiology
  • Diabetes Mellitus, Type 1 / blood*
  • Diabetes Mellitus, Type 1 / complications
  • Female
  • Fetal Death / epidemiology
  • Fetal Death / etiology
  • Follow-Up Studies
  • Glycated Hemoglobin A / analysis*
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Logistic Models
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Outcome*
  • Pregnancy Trimester, First / blood
  • Pregnancy Trimester, First / metabolism
  • Pregnancy in Diabetics / blood*
  • Pregnancy in Diabetics / complications
  • Retrospective Studies
  • Risk Factors
  • Time Factors

Substances

  • Glycated Hemoglobin A