Associations of mid-pregnancy HbA1c with gestational diabetes and risk of adverse pregnancy outcomes in high-risk Taiwanese women
The objective of this study was to investigate the associations among the mid-pregnancy glycated hemoglobin A1c (HbA1c) level, gestational diabetes (GDM), and risk of adverse pregnancy outcomes in women without overt diabetes and with positive 50-g, 1-h glucose challenge test (GCT) results (140 mg/d...
Gespeichert in:
| Veröffentlicht in: | PloS one 2017-05, Vol.12 (5), p.e0177563-e0177563 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | e0177563 |
|---|---|
| container_issue | 5 |
| container_start_page | e0177563 |
| container_title | PloS one |
| container_volume | 12 |
| creator | Ho, Yi-Ran Wang, Panchalli Lu, Mei-Chun Tseng, Shih-Ting Yang, Chun-Pai Yan, Yuan-Horng |
| description | The objective of this study was to investigate the associations among the mid-pregnancy glycated hemoglobin A1c (HbA1c) level, gestational diabetes (GDM), and risk of adverse pregnancy outcomes in women without overt diabetes and with positive 50-g, 1-h glucose challenge test (GCT) results (140 mg/dL or greater).
This prospective study enrolled 1,989 pregnant Taiwanese women. A two-step approach, including a 50-g, 1-h GCT and 100-g, 3-h oral glucose tolerance test (OGTT), was employed for the diagnosis of GDM at weeks 23-32. The mid-pregnancy HbA1c level was measured at the time the OGTT was performed. A receiver operating characteristic (ROC) curve was used to determine the relationship between the mid-pregnancy HbA1c level and GDM. Multiple logistic regression models were implemented to assess the relationships between the mid-pregnancy HbA1c level and adverse pregnancy outcomes.
An ROC curve demonstrated that the optimal mid-pregnancy HbA1c cut-off point to predict GDM, as diagnosed by the Carpenter-Coustan criteria using a two-step approach, was 5.7%. The area under the ROC curve of the mid-pregnancy HbA1c level for GDM was 0.70. Compared with the levels of 4.5-4.9%, higher mid-pregnancy HbA1c levels (5.0-5.4, 5.5-5.9, 6.0-6.4, 6.5-6.9, and >7.0%) were significantly associated with increased risks of gestational hypertension or preeclampsia, preterm delivery, admission to the neonatal intensive care unit, low birth weight, and macrosomia (the odds ratio [OR] ranges were 1.20-9.98, 1.31-5.16, 0.88-3.15, 0.89-4.10, and 2.22-27.86, respectively).
The mid-pregnancy HbA1c level was associated with various adverse pregnancy outcomes in high-risk Taiwanese women. However, it lacked adequate sensitivity and specificity to replace the two-step approach in the diagnosis of GDM. The current study comprised a single-center prospective study; thus, additional, randomized control design studies are required. |
| doi_str_mv | 10.1371/journal.pone.0177563 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_1899029309</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A491761777</galeid><doaj_id>oai_doaj_org_article_42c45522bcb94ffa9fd8e75ad094c865</doaj_id><sourcerecordid>A491761777</sourcerecordid><originalsourceid>FETCH-LOGICAL-c692t-b50f0747efe36fc902ab32de6d3c802fa7548e38d881f4acc651dcb2e4f4435a3</originalsourceid><addsrcrecordid>eNqNk0tv1DAUhSMEoqXwDxBEQkKwyOBnHhukUQV0pEqVoLC1HD8Sl8Se2kmHLvnneGbSMkFdoCwc2d85to_vTZKXECwgLuCHKzd6y7vF2lm1ALAoaI4fJcewwijLEcCPD_6PkmchXAFAcZnnT5MjVFJAEaDHye9lCE4YPhhnQ-p02huZrb1qLLfiNj2rl1CkGzO0aaPCsMN4l0rDazWokHIrU2_Cz62Syxvlg0r_qt04CNdHzNi0NU2b7dBLbjbcqkhu4qJ9njzRvAvqxTSeJN8_f7o8PcvOL76sTpfnmcgrNGQ1BRoUpFBa4VyLCiBeYyRVLrEoAdK8oKRUuJRlCTXhQuQUSlEjRTQhmHJ8krze-647F9iUXmCwrKJXhUEVidWekI5fsbU3Pfe3zHHDdhPON4z7wYhOMYIEoRShWtQV0ZpXWpaqoFyCiogyp9Hr47TbWPdKCmUHz7uZ6XzFmpY17oZRghHM82jwbjLw7nqM2bPeBKG6Lkbnxv25CUQVKCP65h_04dtNVMPjBYzVLu4rtqZsSSpY5LGEikgtHqDiJ1VvRCw1beL8TPB-JojMoH4NDR9DYKtvX_-fvfgxZ98esK3i3dAG1427Qp2DZA8K70LwSt-HDAHbdspdGmzbKWzqlCh7dfhA96K71sB_AGouEE0</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1899029309</pqid></control><display><type>article</type><title>Associations of mid-pregnancy HbA1c with gestational diabetes and risk of adverse pregnancy outcomes in high-risk Taiwanese women</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Public Library of Science (PLoS)</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><creator>Ho, Yi-Ran ; Wang, Panchalli ; Lu, Mei-Chun ; Tseng, Shih-Ting ; Yang, Chun-Pai ; Yan, Yuan-Horng</creator><contributor>Spracklen, Cassandra Nichole</contributor><creatorcontrib>Ho, Yi-Ran ; Wang, Panchalli ; Lu, Mei-Chun ; Tseng, Shih-Ting ; Yang, Chun-Pai ; Yan, Yuan-Horng ; Spracklen, Cassandra Nichole</creatorcontrib><description>The objective of this study was to investigate the associations among the mid-pregnancy glycated hemoglobin A1c (HbA1c) level, gestational diabetes (GDM), and risk of adverse pregnancy outcomes in women without overt diabetes and with positive 50-g, 1-h glucose challenge test (GCT) results (140 mg/dL or greater).
This prospective study enrolled 1,989 pregnant Taiwanese women. A two-step approach, including a 50-g, 1-h GCT and 100-g, 3-h oral glucose tolerance test (OGTT), was employed for the diagnosis of GDM at weeks 23-32. The mid-pregnancy HbA1c level was measured at the time the OGTT was performed. A receiver operating characteristic (ROC) curve was used to determine the relationship between the mid-pregnancy HbA1c level and GDM. Multiple logistic regression models were implemented to assess the relationships between the mid-pregnancy HbA1c level and adverse pregnancy outcomes.
An ROC curve demonstrated that the optimal mid-pregnancy HbA1c cut-off point to predict GDM, as diagnosed by the Carpenter-Coustan criteria using a two-step approach, was 5.7%. The area under the ROC curve of the mid-pregnancy HbA1c level for GDM was 0.70. Compared with the levels of 4.5-4.9%, higher mid-pregnancy HbA1c levels (5.0-5.4, 5.5-5.9, 6.0-6.4, 6.5-6.9, and >7.0%) were significantly associated with increased risks of gestational hypertension or preeclampsia, preterm delivery, admission to the neonatal intensive care unit, low birth weight, and macrosomia (the odds ratio [OR] ranges were 1.20-9.98, 1.31-5.16, 0.88-3.15, 0.89-4.10, and 2.22-27.86, respectively).
The mid-pregnancy HbA1c level was associated with various adverse pregnancy outcomes in high-risk Taiwanese women. However, it lacked adequate sensitivity and specificity to replace the two-step approach in the diagnosis of GDM. The current study comprised a single-center prospective study; thus, additional, randomized control design studies are required.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0177563</identifier><identifier>PMID: 28505205</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Adults ; Age ; Angiography ; Asian Continental Ancestry Group ; Biology and life sciences ; Biomarkers ; Blood glucose ; Body mass ; Body mass index ; Cancer ; Cardiovascular diseases ; Control ; Criteria ; Cut-off ; Diabetes ; Diabetes mellitus ; Diabetes, Gestational - blood ; Diabetes, Gestational - diagnosis ; Diabetes, Gestational - epidemiology ; Diagnosis ; Diagnostic software ; Diagnostic systems ; Downloading ; Electronic mail ; Endocrinology ; Female ; Fetuses ; Food ; Format ; Gestation ; Gestational diabetes ; Glucose ; Glucose tolerance ; Glycated Hemoglobin A ; Gynecology ; Health aspects ; Health risk assessment ; Health risks ; Hemoglobin ; Humans ; Hygiene ; Hyperglycemia ; Infant, Newborn ; Maternal & child health ; Measurement ; Medical diagnosis ; Medical records ; Medicine and health sciences ; Metabolism ; Mortality ; Neurology ; Nutrition ; Obstetrics ; Odds Ratio ; Pregnancy ; Pregnancy Outcome ; Public health ; Public Health Surveillance ; Regression models ; Risk ; Risk factors ; ROC Curve ; Taiwan - epidemiology</subject><ispartof>PloS one, 2017-05, Vol.12 (5), p.e0177563-e0177563</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Ho et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2017 Ho et al 2017 Ho et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-b50f0747efe36fc902ab32de6d3c802fa7548e38d881f4acc651dcb2e4f4435a3</citedby><cites>FETCH-LOGICAL-c692t-b50f0747efe36fc902ab32de6d3c802fa7548e38d881f4acc651dcb2e4f4435a3</cites><orcidid>0000-0003-3865-9057</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5432166/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5432166/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53769,53771,79346,79347</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28505205$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Spracklen, Cassandra Nichole</contributor><creatorcontrib>Ho, Yi-Ran</creatorcontrib><creatorcontrib>Wang, Panchalli</creatorcontrib><creatorcontrib>Lu, Mei-Chun</creatorcontrib><creatorcontrib>Tseng, Shih-Ting</creatorcontrib><creatorcontrib>Yang, Chun-Pai</creatorcontrib><creatorcontrib>Yan, Yuan-Horng</creatorcontrib><title>Associations of mid-pregnancy HbA1c with gestational diabetes and risk of adverse pregnancy outcomes in high-risk Taiwanese women</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The objective of this study was to investigate the associations among the mid-pregnancy glycated hemoglobin A1c (HbA1c) level, gestational diabetes (GDM), and risk of adverse pregnancy outcomes in women without overt diabetes and with positive 50-g, 1-h glucose challenge test (GCT) results (140 mg/dL or greater).
This prospective study enrolled 1,989 pregnant Taiwanese women. A two-step approach, including a 50-g, 1-h GCT and 100-g, 3-h oral glucose tolerance test (OGTT), was employed for the diagnosis of GDM at weeks 23-32. The mid-pregnancy HbA1c level was measured at the time the OGTT was performed. A receiver operating characteristic (ROC) curve was used to determine the relationship between the mid-pregnancy HbA1c level and GDM. Multiple logistic regression models were implemented to assess the relationships between the mid-pregnancy HbA1c level and adverse pregnancy outcomes.
An ROC curve demonstrated that the optimal mid-pregnancy HbA1c cut-off point to predict GDM, as diagnosed by the Carpenter-Coustan criteria using a two-step approach, was 5.7%. The area under the ROC curve of the mid-pregnancy HbA1c level for GDM was 0.70. Compared with the levels of 4.5-4.9%, higher mid-pregnancy HbA1c levels (5.0-5.4, 5.5-5.9, 6.0-6.4, 6.5-6.9, and >7.0%) were significantly associated with increased risks of gestational hypertension or preeclampsia, preterm delivery, admission to the neonatal intensive care unit, low birth weight, and macrosomia (the odds ratio [OR] ranges were 1.20-9.98, 1.31-5.16, 0.88-3.15, 0.89-4.10, and 2.22-27.86, respectively).
The mid-pregnancy HbA1c level was associated with various adverse pregnancy outcomes in high-risk Taiwanese women. However, it lacked adequate sensitivity and specificity to replace the two-step approach in the diagnosis of GDM. The current study comprised a single-center prospective study; thus, additional, randomized control design studies are required.</description><subject>Adult</subject><subject>Adults</subject><subject>Age</subject><subject>Angiography</subject><subject>Asian Continental Ancestry Group</subject><subject>Biology and life sciences</subject><subject>Biomarkers</subject><subject>Blood glucose</subject><subject>Body mass</subject><subject>Body mass index</subject><subject>Cancer</subject><subject>Cardiovascular diseases</subject><subject>Control</subject><subject>Criteria</subject><subject>Cut-off</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes, Gestational - blood</subject><subject>Diabetes, Gestational - diagnosis</subject><subject>Diabetes, Gestational - epidemiology</subject><subject>Diagnosis</subject><subject>Diagnostic software</subject><subject>Diagnostic systems</subject><subject>Downloading</subject><subject>Electronic mail</subject><subject>Endocrinology</subject><subject>Female</subject><subject>Fetuses</subject><subject>Food</subject><subject>Format</subject><subject>Gestation</subject><subject>Gestational diabetes</subject><subject>Glucose</subject><subject>Glucose tolerance</subject><subject>Glycated Hemoglobin A</subject><subject>Gynecology</subject><subject>Health aspects</subject><subject>Health risk assessment</subject><subject>Health risks</subject><subject>Hemoglobin</subject><subject>Humans</subject><subject>Hygiene</subject><subject>Hyperglycemia</subject><subject>Infant, Newborn</subject><subject>Maternal & child health</subject><subject>Measurement</subject><subject>Medical diagnosis</subject><subject>Medical records</subject><subject>Medicine and health sciences</subject><subject>Metabolism</subject><subject>Mortality</subject><subject>Neurology</subject><subject>Nutrition</subject><subject>Obstetrics</subject><subject>Odds Ratio</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome</subject><subject>Public health</subject><subject>Public Health Surveillance</subject><subject>Regression models</subject><subject>Risk</subject><subject>Risk factors</subject><subject>ROC Curve</subject><subject>Taiwan - epidemiology</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk0tv1DAUhSMEoqXwDxBEQkKwyOBnHhukUQV0pEqVoLC1HD8Sl8Se2kmHLvnneGbSMkFdoCwc2d85to_vTZKXECwgLuCHKzd6y7vF2lm1ALAoaI4fJcewwijLEcCPD_6PkmchXAFAcZnnT5MjVFJAEaDHye9lCE4YPhhnQ-p02huZrb1qLLfiNj2rl1CkGzO0aaPCsMN4l0rDazWokHIrU2_Cz62Syxvlg0r_qt04CNdHzNi0NU2b7dBLbjbcqkhu4qJ9njzRvAvqxTSeJN8_f7o8PcvOL76sTpfnmcgrNGQ1BRoUpFBa4VyLCiBeYyRVLrEoAdK8oKRUuJRlCTXhQuQUSlEjRTQhmHJ8krze-647F9iUXmCwrKJXhUEVidWekI5fsbU3Pfe3zHHDdhPON4z7wYhOMYIEoRShWtQV0ZpXWpaqoFyCiogyp9Hr47TbWPdKCmUHz7uZ6XzFmpY17oZRghHM82jwbjLw7nqM2bPeBKG6Lkbnxv25CUQVKCP65h_04dtNVMPjBYzVLu4rtqZsSSpY5LGEikgtHqDiJ1VvRCw1beL8TPB-JojMoH4NDR9DYKtvX_-fvfgxZ98esK3i3dAG1427Qp2DZA8K70LwSt-HDAHbdspdGmzbKWzqlCh7dfhA96K71sB_AGouEE0</recordid><startdate>20170515</startdate><enddate>20170515</enddate><creator>Ho, Yi-Ran</creator><creator>Wang, Panchalli</creator><creator>Lu, Mei-Chun</creator><creator>Tseng, Shih-Ting</creator><creator>Yang, Chun-Pai</creator><creator>Yan, Yuan-Horng</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-3865-9057</orcidid></search><sort><creationdate>20170515</creationdate><title>Associations of mid-pregnancy HbA1c with gestational diabetes and risk of adverse pregnancy outcomes in high-risk Taiwanese women</title><author>Ho, Yi-Ran ; Wang, Panchalli ; Lu, Mei-Chun ; Tseng, Shih-Ting ; Yang, Chun-Pai ; Yan, Yuan-Horng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-b50f0747efe36fc902ab32de6d3c802fa7548e38d881f4acc651dcb2e4f4435a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Adults</topic><topic>Age</topic><topic>Angiography</topic><topic>Asian Continental Ancestry Group</topic><topic>Biology and life sciences</topic><topic>Biomarkers</topic><topic>Blood glucose</topic><topic>Body mass</topic><topic>Body mass index</topic><topic>Cancer</topic><topic>Cardiovascular diseases</topic><topic>Control</topic><topic>Criteria</topic><topic>Cut-off</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes, Gestational - blood</topic><topic>Diabetes, Gestational - diagnosis</topic><topic>Diabetes, Gestational - epidemiology</topic><topic>Diagnosis</topic><topic>Diagnostic software</topic><topic>Diagnostic systems</topic><topic>Downloading</topic><topic>Electronic mail</topic><topic>Endocrinology</topic><topic>Female</topic><topic>Fetuses</topic><topic>Food</topic><topic>Format</topic><topic>Gestation</topic><topic>Gestational diabetes</topic><topic>Glucose</topic><topic>Glucose tolerance</topic><topic>Glycated Hemoglobin A</topic><topic>Gynecology</topic><topic>Health aspects</topic><topic>Health risk assessment</topic><topic>Health risks</topic><topic>Hemoglobin</topic><topic>Humans</topic><topic>Hygiene</topic><topic>Hyperglycemia</topic><topic>Infant, Newborn</topic><topic>Maternal & child health</topic><topic>Measurement</topic><topic>Medical diagnosis</topic><topic>Medical records</topic><topic>Medicine and health sciences</topic><topic>Metabolism</topic><topic>Mortality</topic><topic>Neurology</topic><topic>Nutrition</topic><topic>Obstetrics</topic><topic>Odds Ratio</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome</topic><topic>Public health</topic><topic>Public Health Surveillance</topic><topic>Regression models</topic><topic>Risk</topic><topic>Risk factors</topic><topic>ROC Curve</topic><topic>Taiwan - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ho, Yi-Ran</creatorcontrib><creatorcontrib>Wang, Panchalli</creatorcontrib><creatorcontrib>Lu, Mei-Chun</creatorcontrib><creatorcontrib>Tseng, Shih-Ting</creatorcontrib><creatorcontrib>Yang, Chun-Pai</creatorcontrib><creatorcontrib>Yan, Yuan-Horng</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ho, Yi-Ran</au><au>Wang, Panchalli</au><au>Lu, Mei-Chun</au><au>Tseng, Shih-Ting</au><au>Yang, Chun-Pai</au><au>Yan, Yuan-Horng</au><au>Spracklen, Cassandra Nichole</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Associations of mid-pregnancy HbA1c with gestational diabetes and risk of adverse pregnancy outcomes in high-risk Taiwanese women</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2017-05-15</date><risdate>2017</risdate><volume>12</volume><issue>5</issue><spage>e0177563</spage><epage>e0177563</epage><pages>e0177563-e0177563</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The objective of this study was to investigate the associations among the mid-pregnancy glycated hemoglobin A1c (HbA1c) level, gestational diabetes (GDM), and risk of adverse pregnancy outcomes in women without overt diabetes and with positive 50-g, 1-h glucose challenge test (GCT) results (140 mg/dL or greater).
This prospective study enrolled 1,989 pregnant Taiwanese women. A two-step approach, including a 50-g, 1-h GCT and 100-g, 3-h oral glucose tolerance test (OGTT), was employed for the diagnosis of GDM at weeks 23-32. The mid-pregnancy HbA1c level was measured at the time the OGTT was performed. A receiver operating characteristic (ROC) curve was used to determine the relationship between the mid-pregnancy HbA1c level and GDM. Multiple logistic regression models were implemented to assess the relationships between the mid-pregnancy HbA1c level and adverse pregnancy outcomes.
An ROC curve demonstrated that the optimal mid-pregnancy HbA1c cut-off point to predict GDM, as diagnosed by the Carpenter-Coustan criteria using a two-step approach, was 5.7%. The area under the ROC curve of the mid-pregnancy HbA1c level for GDM was 0.70. Compared with the levels of 4.5-4.9%, higher mid-pregnancy HbA1c levels (5.0-5.4, 5.5-5.9, 6.0-6.4, 6.5-6.9, and >7.0%) were significantly associated with increased risks of gestational hypertension or preeclampsia, preterm delivery, admission to the neonatal intensive care unit, low birth weight, and macrosomia (the odds ratio [OR] ranges were 1.20-9.98, 1.31-5.16, 0.88-3.15, 0.89-4.10, and 2.22-27.86, respectively).
The mid-pregnancy HbA1c level was associated with various adverse pregnancy outcomes in high-risk Taiwanese women. However, it lacked adequate sensitivity and specificity to replace the two-step approach in the diagnosis of GDM. The current study comprised a single-center prospective study; thus, additional, randomized control design studies are required.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28505205</pmid><doi>10.1371/journal.pone.0177563</doi><tpages>e0177563</tpages><orcidid>https://orcid.org/0000-0003-3865-9057</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2017-05, Vol.12 (5), p.e0177563-e0177563 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1899029309 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adult Adults Age Angiography Asian Continental Ancestry Group Biology and life sciences Biomarkers Blood glucose Body mass Body mass index Cancer Cardiovascular diseases Control Criteria Cut-off Diabetes Diabetes mellitus Diabetes, Gestational - blood Diabetes, Gestational - diagnosis Diabetes, Gestational - epidemiology Diagnosis Diagnostic software Diagnostic systems Downloading Electronic mail Endocrinology Female Fetuses Food Format Gestation Gestational diabetes Glucose Glucose tolerance Glycated Hemoglobin A Gynecology Health aspects Health risk assessment Health risks Hemoglobin Humans Hygiene Hyperglycemia Infant, Newborn Maternal & child health Measurement Medical diagnosis Medical records Medicine and health sciences Metabolism Mortality Neurology Nutrition Obstetrics Odds Ratio Pregnancy Pregnancy Outcome Public health Public Health Surveillance Regression models Risk Risk factors ROC Curve Taiwan - epidemiology |
| title | Associations of mid-pregnancy HbA1c with gestational diabetes and risk of adverse pregnancy outcomes in high-risk Taiwanese women |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-26T22%3A35%3A21IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Associations%20of%20mid-pregnancy%20HbA1c%20with%20gestational%20diabetes%20and%20risk%20of%20adverse%20pregnancy%20outcomes%20in%20high-risk%20Taiwanese%20women&rft.jtitle=PloS%20one&rft.au=Ho,%20Yi-Ran&rft.date=2017-05-15&rft.volume=12&rft.issue=5&rft.spage=e0177563&rft.epage=e0177563&rft.pages=e0177563-e0177563&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0177563&rft_dat=%3Cgale_plos_%3EA491761777%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1899029309&rft_id=info:pmid/28505205&rft_galeid=A491761777&rft_doaj_id=oai_doaj_org_article_42c45522bcb94ffa9fd8e75ad094c865&rfr_iscdi=true |