Performance of early pregnancy HbA1c for predicting gestational diabetes mellitus and adverse pregnancy outcomes in obese European women
•Early pregnancy HbA1c is a poor predictor of gestational diabetes.•An HbA1c ≥ 5.7% (39 mmol/mol) has poor sensitivity for GDM regardless of gestation.•An HbA1c ≥ 5.7% (39 mmol/mol) was not associated with greater risk of adverse outcomes. To investigate the performance of early pregnancy HbA1c for...
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| creator | Immanuel, Jincy Simmons, David Desoye, Gernot Corcoy, Rosa Adelantado, Juan M. Devlieger, Roland Lapolla, Annunziata Dalfra, Maria G. Bertolotto, Alessandra Harreiter, Jürgen Wender-Ozegowska, Ewa Zawiejska, Agnieszka Dunne, Fidelma P. Damm, Peter Mathiesen, Elisabeth R. Jensen, Dorte M. Andersen, Lise Lotte T. Hill, David J. Jelsma, Judith G.M. Snoek, Frank J. Scharnagl, Hubert Galjaard, Sander Kautzky-Willer, Alexandra VAN Poppel, Mireille N.M. |
| description | •Early pregnancy HbA1c is a poor predictor of gestational diabetes.•An HbA1c ≥ 5.7% (39 mmol/mol) has poor sensitivity for GDM regardless of gestation.•An HbA1c ≥ 5.7% (39 mmol/mol) was not associated with greater risk of adverse outcomes.
To investigate the performance of early pregnancy HbA1c for predicting gestational diabetes mellitus (GDM) and adverse pregnancy outcomes in obese women.
Post hoc analysis using data from the Vitamin D And Lifestyle Intervention for GDM prevention trials conducted across 9 European countries (2012–2014). Pregnant women (BMI ≥ 29 kg/m2) underwent a baseline HbA1c and oral glucose tolerance tests at |
| doi_str_mv | 10.1016/j.diabres.2020.108378 |
| format | Article |
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To investigate the performance of early pregnancy HbA1c for predicting gestational diabetes mellitus (GDM) and adverse pregnancy outcomes in obese women.
Post hoc analysis using data from the Vitamin D And Lifestyle Intervention for GDM prevention trials conducted across 9 European countries (2012–2014). Pregnant women (BMI ≥ 29 kg/m2) underwent a baseline HbA1c and oral glucose tolerance tests at < 20 weeks, 24–28 weeks, and 35–37 weeks. Women with GDM were referred for treatment.
Among the 869 women tested, the prevalence of GDM was 25.9% before 20 weeks, with a further 8.6% at 24–28 weeks. The areas under the curves for HbA1c at the two time points were 0.55 (0.50–0.59) and 0.54 (0.47–0.61), respectively. An early HbA1c ≥ 5.7% (39 mmol/mol) (N = 111) showed low sensitivity (18.2%) with 89.1% specificity for GDM before 20 weeks, at 24–28 weeks (sensitivity of 8.0% and specificity of 88.6% after excluding early GDM), and throughout gestation (sensitivity of 15.9% and specificity of 89.4%). The ≥ 5.7% (39 mmol/mol) threshold was significantly associated with concurrent GDM before 20 weeks (adjusted OR (aOR) 2.77(1.39–5.51)) and throughout gestation (aOR 1.72 (1.02–2.89)), but not adverse pregnancy outcomes.
Early pregnancy HbA1c is of limited use for predicting either GDM or adverse outcomes in overweight/obese European women.</description><identifier>ISSN: 0168-8227</identifier><identifier>EISSN: 1872-8227</identifier><identifier>DOI: 10.1016/j.diabres.2020.108378</identifier><language>eng</language><publisher>Elsevier B.V</publisher><subject>Diagnostic threshold ; Gestational diabetes mellitus ; Hemoglobin A1c ; Odds Ratio ; Pregnancy ; Pregnancy outcome</subject><ispartof>Diabetes research and clinical practice, 2020-10, Vol.168, p.108378-108378, Article 108378</ispartof><rights>2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c389t-a9a10c01b10d073628fb10568e332e60615eae198976ddf80a0a8e5c909109ec3</citedby><cites>FETCH-LOGICAL-c389t-a9a10c01b10d073628fb10568e332e60615eae198976ddf80a0a8e5c909109ec3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.diabres.2020.108378$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids></links><search><creatorcontrib>Immanuel, Jincy</creatorcontrib><creatorcontrib>Simmons, David</creatorcontrib><creatorcontrib>Desoye, Gernot</creatorcontrib><creatorcontrib>Corcoy, Rosa</creatorcontrib><creatorcontrib>Adelantado, Juan M.</creatorcontrib><creatorcontrib>Devlieger, Roland</creatorcontrib><creatorcontrib>Lapolla, Annunziata</creatorcontrib><creatorcontrib>Dalfra, Maria G.</creatorcontrib><creatorcontrib>Bertolotto, Alessandra</creatorcontrib><creatorcontrib>Harreiter, Jürgen</creatorcontrib><creatorcontrib>Wender-Ozegowska, Ewa</creatorcontrib><creatorcontrib>Zawiejska, Agnieszka</creatorcontrib><creatorcontrib>Dunne, Fidelma P.</creatorcontrib><creatorcontrib>Damm, Peter</creatorcontrib><creatorcontrib>Mathiesen, Elisabeth R.</creatorcontrib><creatorcontrib>Jensen, Dorte M.</creatorcontrib><creatorcontrib>Andersen, Lise Lotte T.</creatorcontrib><creatorcontrib>Hill, David J.</creatorcontrib><creatorcontrib>Jelsma, Judith G.M.</creatorcontrib><creatorcontrib>Snoek, Frank J.</creatorcontrib><creatorcontrib>Scharnagl, Hubert</creatorcontrib><creatorcontrib>Galjaard, Sander</creatorcontrib><creatorcontrib>Kautzky-Willer, Alexandra</creatorcontrib><creatorcontrib>VAN Poppel, Mireille N.M.</creatorcontrib><title>Performance of early pregnancy HbA1c for predicting gestational diabetes mellitus and adverse pregnancy outcomes in obese European women</title><title>Diabetes research and clinical practice</title><description>•Early pregnancy HbA1c is a poor predictor of gestational diabetes.•An HbA1c ≥ 5.7% (39 mmol/mol) has poor sensitivity for GDM regardless of gestation.•An HbA1c ≥ 5.7% (39 mmol/mol) was not associated with greater risk of adverse outcomes.
To investigate the performance of early pregnancy HbA1c for predicting gestational diabetes mellitus (GDM) and adverse pregnancy outcomes in obese women.
Post hoc analysis using data from the Vitamin D And Lifestyle Intervention for GDM prevention trials conducted across 9 European countries (2012–2014). Pregnant women (BMI ≥ 29 kg/m2) underwent a baseline HbA1c and oral glucose tolerance tests at < 20 weeks, 24–28 weeks, and 35–37 weeks. Women with GDM were referred for treatment.
Among the 869 women tested, the prevalence of GDM was 25.9% before 20 weeks, with a further 8.6% at 24–28 weeks. The areas under the curves for HbA1c at the two time points were 0.55 (0.50–0.59) and 0.54 (0.47–0.61), respectively. An early HbA1c ≥ 5.7% (39 mmol/mol) (N = 111) showed low sensitivity (18.2%) with 89.1% specificity for GDM before 20 weeks, at 24–28 weeks (sensitivity of 8.0% and specificity of 88.6% after excluding early GDM), and throughout gestation (sensitivity of 15.9% and specificity of 89.4%). The ≥ 5.7% (39 mmol/mol) threshold was significantly associated with concurrent GDM before 20 weeks (adjusted OR (aOR) 2.77(1.39–5.51)) and throughout gestation (aOR 1.72 (1.02–2.89)), but not adverse pregnancy outcomes.
Early pregnancy HbA1c is of limited use for predicting either GDM or adverse outcomes in overweight/obese European women.</description><subject>Diagnostic threshold</subject><subject>Gestational diabetes mellitus</subject><subject>Hemoglobin A1c</subject><subject>Odds Ratio</subject><subject>Pregnancy</subject><subject>Pregnancy outcome</subject><issn>0168-8227</issn><issn>1872-8227</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNqFkLFOwzAQhi0EEqXwCEgeWVJsp3GcCVVVoUhIMMBsufalcpXYwU6K-gY8Ng7twMZ0p_----37EbqlZEYJ5fe7mbFqEyDOGGGjJvJSnKEJFSXLBGPlOZokTvz2l-gqxh0hhOfzYoK-3yDUPrTKacC-xqBCc8BdgK1L0gGvNwuqcSJGzVjdW7fFW4i96q13qsHj09BDxC00je2HiJUzWJk9hAh_jPzQa98mzjrsN5BmqyH4DpTDX0l31-iiVk2Em1Odoo_H1ftynb28Pj0vFy-ZzkXVZ6pSlGhCN5QYUuaciTq1BReQ5ww44bQABbQSVcmNqQVRRAkodEUqSirQ-RTdHX274D-HdIhsbdTp78qBH6Jk85wLXnLKElocUR18jAFq2QXbqnCQlMgxebmTp-TlmLw8Jp_2Ho57kO7YWwgyagspYGMD6F4ab_9x-AF3c5Fa</recordid><startdate>202010</startdate><enddate>202010</enddate><creator>Immanuel, Jincy</creator><creator>Simmons, David</creator><creator>Desoye, Gernot</creator><creator>Corcoy, Rosa</creator><creator>Adelantado, Juan M.</creator><creator>Devlieger, Roland</creator><creator>Lapolla, Annunziata</creator><creator>Dalfra, Maria G.</creator><creator>Bertolotto, Alessandra</creator><creator>Harreiter, Jürgen</creator><creator>Wender-Ozegowska, Ewa</creator><creator>Zawiejska, Agnieszka</creator><creator>Dunne, Fidelma P.</creator><creator>Damm, Peter</creator><creator>Mathiesen, Elisabeth R.</creator><creator>Jensen, Dorte M.</creator><creator>Andersen, Lise Lotte T.</creator><creator>Hill, David J.</creator><creator>Jelsma, Judith G.M.</creator><creator>Snoek, Frank J.</creator><creator>Scharnagl, Hubert</creator><creator>Galjaard, Sander</creator><creator>Kautzky-Willer, Alexandra</creator><creator>VAN Poppel, Mireille N.M.</creator><general>Elsevier B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202010</creationdate><title>Performance of early pregnancy HbA1c for predicting gestational diabetes mellitus and adverse pregnancy outcomes in obese European women</title><author>Immanuel, Jincy ; 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To investigate the performance of early pregnancy HbA1c for predicting gestational diabetes mellitus (GDM) and adverse pregnancy outcomes in obese women.
Post hoc analysis using data from the Vitamin D And Lifestyle Intervention for GDM prevention trials conducted across 9 European countries (2012–2014). Pregnant women (BMI ≥ 29 kg/m2) underwent a baseline HbA1c and oral glucose tolerance tests at < 20 weeks, 24–28 weeks, and 35–37 weeks. Women with GDM were referred for treatment.
Among the 869 women tested, the prevalence of GDM was 25.9% before 20 weeks, with a further 8.6% at 24–28 weeks. The areas under the curves for HbA1c at the two time points were 0.55 (0.50–0.59) and 0.54 (0.47–0.61), respectively. An early HbA1c ≥ 5.7% (39 mmol/mol) (N = 111) showed low sensitivity (18.2%) with 89.1% specificity for GDM before 20 weeks, at 24–28 weeks (sensitivity of 8.0% and specificity of 88.6% after excluding early GDM), and throughout gestation (sensitivity of 15.9% and specificity of 89.4%). The ≥ 5.7% (39 mmol/mol) threshold was significantly associated with concurrent GDM before 20 weeks (adjusted OR (aOR) 2.77(1.39–5.51)) and throughout gestation (aOR 1.72 (1.02–2.89)), but not adverse pregnancy outcomes.
Early pregnancy HbA1c is of limited use for predicting either GDM or adverse outcomes in overweight/obese European women.</abstract><pub>Elsevier B.V</pub><doi>10.1016/j.diabres.2020.108378</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Diagnostic threshold Gestational diabetes mellitus Hemoglobin A1c Odds Ratio Pregnancy Pregnancy outcome |
| title | Performance of early pregnancy HbA1c for predicting gestational diabetes mellitus and adverse pregnancy outcomes in obese European women |
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