1970-LB: A Sugary Recipe for Adverse Outcomes? Third Trimester HbA1c and Composite Obstetric and Perinatal Adverse Outcomes, a Prospective Study

Objective: to evaluate the association between elevated HbA1c levels close to delivery and the increased risks of composite obstetric and perinatal adverse outcomes. Method: women with singleton pregnancies, at 34 weeks or above admitted for delivery were invited. HbA1c levels were obtained during the admission. The composite obstetrics and perinatal adverse outcomes were collected and analyzed. Results: 609 participants were included. The PPV of HbA1c > 5.8% in diabetes is 68% and the NPV is 91%. HbA1c > 5.8% is associated with increased odds of Cesarean section, primary Cesarean section, postpartum hemorrhage, hypertensive disorders in pregnancy, macrosomia, NICU admission, hypoglycemia, respiratory morbidity, and any perinatal adverse events. The outcomes were analyzed after the adjustment for confounders with multivariable logistic regression, the elevated HbA1c levels were still associated with increased cesarean section, primary cesarean section, macrosomia, neonatal hypoglycemia, and any perinatal adverse events. Conclusion: third-trimester HbA1c > 5.8% is associated with higher odds of several major obstetric and perinatal adverse outcomes and could be a useful tool during prenatal care to improve pregnancy outcomes.