Third trimester HbA1c and the association with large-for-gestational-age neonates in women with gestational diabetes
Arch. endocrinol. metab. (Online)
;
65(3): 328-335, May-June 2021. tab, graf
Article
in English
| LILACS
| ID: biblio-1285149
ABSTRACT
ABSTRACT Objective:
To evaluate the association between HbA1c levels measured in the third trimester and the risk for large for gestational age (LGA) in neonates of mothers affected by gestational diabetes mellitus (GDM). Secondarily, we aimed to identify an ideal cut-off for increased risk of LGA amongst pregnant women with GDM. Materials andmethods:
Observational retrospective review of singleton pregnant women with GDM evaluated in a diabetes and pregnancy clinic of a tertiary and academic hospital. From January/2011 to December/2017, 1,085 pregnant women underwent evaluation due to GDM, of which 665 had an HbA1c test in the third trimester. A logistic regression model was performed to evaluate predictors of LGA. A receiver-operating-characteristic (ROC) curve was used to evaluate the predictive ability of third trimester HbA1c for LGA identification.Results:
A total of 1,085 singleton pregnant women were evaluated during the study period, with a mean age of 32.9 ± 5.3 years. In the multivariate analysis, OGTT at 0 minutes (OR 1.040; CI 95% 1.006-1.076, p = 0.022) and third trimester HbA1c (OR 4.680; CI 95% 1.210-18.107, p = 0.025) were associated with LGA newborns. Using a ROC curve to evaluate the predictive ability of third trimester HbA1c for LGA identification, the optimal HbA1c cut-off point was 5.4% where the sensitivity was 77.4% and the specificity was 71.7% (AUC 0.782; p < 0.001).Conclusions:
Few studies in the Mediterranean population have evaluated the role of HbA1c in predicting neonatal complications in women with GDM. A third trimester HbA1c > 5.4% was found to have good sensitivity and specificity for identifying the risk of LGA.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Diabetes, Gestational
Type of study:
Observational study
/
Prognostic study
/
Risk factors
Limits:
Adult
/
Female
/
Humans
/
Infant, Newborn
/
Pregnancy
Language:
English
Journal:
Arch. endocrinol. metab. (Online)
Journal subject:
Endocrinology
/
Metabolism
Year:
2021
Type:
Article
Affiliation country:
Portugal
Institution/Affiliation country:
Centro Materno-Infantil do Norte/PT
/
Hospital de Braga/PT
/
Universitário do Porto/PT
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