Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study: Associations of maternal A1C and glucose with pregnancy outcomes
OBJECTIVE: To compare associations of maternal glucose and A1C with adverse outcomes in the multinational Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study and determine, based on those comparisons, if A1C measurement can provide an alternative to an oral glucose tolerance test (OGTT) in preg...
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| Veröffentlicht in: | Diabetes care 2012-03, Vol.35 (3), p.574-580 |
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| creator | Lowe, Lynn P Metzger, Boyd E Dyer, Alan R Lowe, Julia McCance, David R Lappin, Terence R.J Trimble, Elisabeth R Coustan, Donald R Hadden, David R Hod, Moshe Oats, Jeremy J.N Persson, Bengt |
| description | OBJECTIVE: To compare associations of maternal glucose and A1C with adverse outcomes in the multinational Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study and determine, based on those comparisons, if A1C measurement can provide an alternative to an oral glucose tolerance test (OGTT) in pregnant women. RESEARCH DESIGN AND METHODS: Eligible pregnant women underwent a 75-g OGTT at 24–32 weeks’ gestation. A sample for A1C was also collected. Neonatal anthropometrics and cord serum C-peptide were measured. Associations with outcomes were assessed using multiple logistic regression with adjustment for potential confounders. RESULTS: Among 23,316 HAPO Study participants with glucose levels blinded to caregivers, 21,064 had a nonvariant A1C result. The mean ± SD A1C was 4.79 ± 0.40%. Associations were significantly stronger with glucose measures than with A1C for birth weight, sum of skinfolds, and percent body fat >90th percentile and for fasting and 1-h glucose for cord C-peptide (all P < 0.01). For example, in fully adjusted models, odds ratios (ORs) for birth weight >90th percentile for each measure higher by 1 SD were 1.39, 1.45, and 1.38, respectively, for fasting, 1-, and 2-h plasma glucose and 1.15 for A1C. ORs for cord C-peptide >90th percentile were 1.56, 1.45, and 1.35 for glucose, respectively, and 1.32 for A1C. ORs were similar for glucose and A1C for primary cesarean section, preeclampsia, and preterm delivery. CONCLUSIONS: On the basis of associations with adverse outcomes, these findings suggest that A1C measurement is not a useful alternative to an OGTT in pregnant women. |
| doi_str_mv | 10.2337/dc11-1687 |
| format | Article |
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RESEARCH DESIGN AND METHODS: Eligible pregnant women underwent a 75-g OGTT at 24–32 weeks’ gestation. A sample for A1C was also collected. Neonatal anthropometrics and cord serum C-peptide were measured. Associations with outcomes were assessed using multiple logistic regression with adjustment for potential confounders. RESULTS: Among 23,316 HAPO Study participants with glucose levels blinded to caregivers, 21,064 had a nonvariant A1C result. The mean ± SD A1C was 4.79 ± 0.40%. Associations were significantly stronger with glucose measures than with A1C for birth weight, sum of skinfolds, and percent body fat >90th percentile and for fasting and 1-h glucose for cord C-peptide (all P < 0.01). For example, in fully adjusted models, odds ratios (ORs) for birth weight >90th percentile for each measure higher by 1 SD were 1.39, 1.45, and 1.38, respectively, for fasting, 1-, and 2-h plasma glucose and 1.15 for A1C. ORs for cord C-peptide >90th percentile were 1.56, 1.45, and 1.35 for glucose, respectively, and 1.32 for A1C. ORs were similar for glucose and A1C for primary cesarean section, preeclampsia, and preterm delivery. CONCLUSIONS: On the basis of associations with adverse outcomes, these findings suggest that A1C measurement is not a useful alternative to an OGTT in pregnant women.</description><identifier>ISSN: 0149-5992</identifier><identifier>EISSN: 1935-5548</identifier><identifier>DOI: 10.2337/dc11-1687</identifier><identifier>PMID: 22301123</identifier><identifier>CODEN: DICAD2</identifier><language>eng</language><publisher>Alexandria, VA: American Diabetes Association</publisher><subject>Adult ; Analysis ; Biological and medical sciences ; birth weight ; blood glucose ; Blood Glucose - metabolism ; blood serum ; body fat ; c-peptide ; caregivers ; cesarean section ; Dextrose ; Diabetes ; Diabetes, Gestational - blood ; Diabetes. Impaired glucose tolerance ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; fasting ; Female ; Glucose ; glucose tolerance ; Glucose Tolerance Test ; Glucose tolerance tests ; Glycated Hemoglobin A - metabolism ; Humans ; Hyperglycemia ; Hyperglycemia - complications ; Hyperglycemia - physiopathology ; Medical sciences ; Metabolic diseases ; Miscellaneous ; Original Research ; pre-eclampsia ; Pregnancy ; Pregnancy Outcome ; Pregnant women ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; regression analysis ; Womens health</subject><ispartof>Diabetes care, 2012-03, Vol.35 (3), p.574-580</ispartof><rights>2015 INIST-CNRS</rights><rights>COPYRIGHT 2012 American Diabetes Association</rights><rights>Copyright American Diabetes Association Mar 2012</rights><rights>2012 by the American Diabetes Association. 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25610306$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22301123$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lowe, Lynn P</creatorcontrib><creatorcontrib>Metzger, Boyd E</creatorcontrib><creatorcontrib>Dyer, Alan R</creatorcontrib><creatorcontrib>Lowe, Julia</creatorcontrib><creatorcontrib>McCance, David R</creatorcontrib><creatorcontrib>Lappin, Terence R.J</creatorcontrib><creatorcontrib>Trimble, Elisabeth R</creatorcontrib><creatorcontrib>Coustan, Donald R</creatorcontrib><creatorcontrib>Hadden, David R</creatorcontrib><creatorcontrib>Hod, Moshe</creatorcontrib><creatorcontrib>Oats, Jeremy J.N</creatorcontrib><creatorcontrib>Persson, Bengt</creatorcontrib><creatorcontrib>HAPO Study Cooperative Research Group</creatorcontrib><title>Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study: Associations of maternal A1C and glucose with pregnancy outcomes</title><title>Diabetes care</title><addtitle>Diabetes Care</addtitle><description>OBJECTIVE: To compare associations of maternal glucose and A1C with adverse outcomes in the multinational Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study and determine, based on those comparisons, if A1C measurement can provide an alternative to an oral glucose tolerance test (OGTT) in pregnant women. RESEARCH DESIGN AND METHODS: Eligible pregnant women underwent a 75-g OGTT at 24–32 weeks’ gestation. A sample for A1C was also collected. Neonatal anthropometrics and cord serum C-peptide were measured. Associations with outcomes were assessed using multiple logistic regression with adjustment for potential confounders. RESULTS: Among 23,316 HAPO Study participants with glucose levels blinded to caregivers, 21,064 had a nonvariant A1C result. The mean ± SD A1C was 4.79 ± 0.40%. Associations were significantly stronger with glucose measures than with A1C for birth weight, sum of skinfolds, and percent body fat >90th percentile and for fasting and 1-h glucose for cord C-peptide (all P < 0.01). For example, in fully adjusted models, odds ratios (ORs) for birth weight >90th percentile for each measure higher by 1 SD were 1.39, 1.45, and 1.38, respectively, for fasting, 1-, and 2-h plasma glucose and 1.15 for A1C. ORs for cord C-peptide >90th percentile were 1.56, 1.45, and 1.35 for glucose, respectively, and 1.32 for A1C. ORs were similar for glucose and A1C for primary cesarean section, preeclampsia, and preterm delivery. CONCLUSIONS: On the basis of associations with adverse outcomes, these findings suggest that A1C measurement is not a useful alternative to an OGTT in pregnant women.</description><subject>Adult</subject><subject>Analysis</subject><subject>Biological and medical sciences</subject><subject>birth weight</subject><subject>blood glucose</subject><subject>Blood Glucose - metabolism</subject><subject>blood serum</subject><subject>body fat</subject><subject>c-peptide</subject><subject>caregivers</subject><subject>cesarean section</subject><subject>Dextrose</subject><subject>Diabetes</subject><subject>Diabetes, Gestational - blood</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>fasting</subject><subject>Female</subject><subject>Glucose</subject><subject>glucose tolerance</subject><subject>Glucose Tolerance Test</subject><subject>Glucose tolerance tests</subject><subject>Glycated Hemoglobin A - metabolism</subject><subject>Humans</subject><subject>Hyperglycemia</subject><subject>Hyperglycemia - complications</subject><subject>Hyperglycemia - physiopathology</subject><subject>Medical sciences</subject><subject>Metabolic diseases</subject><subject>Miscellaneous</subject><subject>Original Research</subject><subject>pre-eclampsia</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome</subject><subject>Pregnant women</subject><subject>Public health. Hygiene</subject><subject>Public health. 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Impaired glucose tolerance</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>fasting</topic><topic>Female</topic><topic>Glucose</topic><topic>glucose tolerance</topic><topic>Glucose Tolerance Test</topic><topic>Glucose tolerance tests</topic><topic>Glycated Hemoglobin A - metabolism</topic><topic>Humans</topic><topic>Hyperglycemia</topic><topic>Hyperglycemia - complications</topic><topic>Hyperglycemia - physiopathology</topic><topic>Medical sciences</topic><topic>Metabolic diseases</topic><topic>Miscellaneous</topic><topic>Original Research</topic><topic>pre-eclampsia</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome</topic><topic>Pregnant women</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>regression analysis</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lowe, Lynn P</creatorcontrib><creatorcontrib>Metzger, Boyd E</creatorcontrib><creatorcontrib>Dyer, Alan R</creatorcontrib><creatorcontrib>Lowe, Julia</creatorcontrib><creatorcontrib>McCance, David R</creatorcontrib><creatorcontrib>Lappin, Terence R.J</creatorcontrib><creatorcontrib>Trimble, Elisabeth R</creatorcontrib><creatorcontrib>Coustan, Donald R</creatorcontrib><creatorcontrib>Hadden, David R</creatorcontrib><creatorcontrib>Hod, Moshe</creatorcontrib><creatorcontrib>Oats, Jeremy J.N</creatorcontrib><creatorcontrib>Persson, Bengt</creatorcontrib><creatorcontrib>HAPO Study Cooperative Research Group</creatorcontrib><collection>AGRIS</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</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>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech 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>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Agricultural Science Database</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Diabetes care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lowe, Lynn P</au><au>Metzger, Boyd E</au><au>Dyer, Alan R</au><au>Lowe, Julia</au><au>McCance, David R</au><au>Lappin, Terence R.J</au><au>Trimble, Elisabeth R</au><au>Coustan, Donald R</au><au>Hadden, David R</au><au>Hod, Moshe</au><au>Oats, Jeremy J.N</au><au>Persson, Bengt</au><aucorp>HAPO Study Cooperative Research Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study: Associations of maternal A1C and glucose with pregnancy outcomes</atitle><jtitle>Diabetes care</jtitle><addtitle>Diabetes Care</addtitle><date>2012-03-01</date><risdate>2012</risdate><volume>35</volume><issue>3</issue><spage>574</spage><epage>580</epage><pages>574-580</pages><issn>0149-5992</issn><eissn>1935-5548</eissn><coden>DICAD2</coden><abstract>OBJECTIVE: To compare associations of maternal glucose and A1C with adverse outcomes in the multinational Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study and determine, based on those comparisons, if A1C measurement can provide an alternative to an oral glucose tolerance test (OGTT) in pregnant women. RESEARCH DESIGN AND METHODS: Eligible pregnant women underwent a 75-g OGTT at 24–32 weeks’ gestation. A sample for A1C was also collected. Neonatal anthropometrics and cord serum C-peptide were measured. Associations with outcomes were assessed using multiple logistic regression with adjustment for potential confounders. RESULTS: Among 23,316 HAPO Study participants with glucose levels blinded to caregivers, 21,064 had a nonvariant A1C result. The mean ± SD A1C was 4.79 ± 0.40%. Associations were significantly stronger with glucose measures than with A1C for birth weight, sum of skinfolds, and percent body fat >90th percentile and for fasting and 1-h glucose for cord C-peptide (all P < 0.01). For example, in fully adjusted models, odds ratios (ORs) for birth weight >90th percentile for each measure higher by 1 SD were 1.39, 1.45, and 1.38, respectively, for fasting, 1-, and 2-h plasma glucose and 1.15 for A1C. ORs for cord C-peptide >90th percentile were 1.56, 1.45, and 1.35 for glucose, respectively, and 1.32 for A1C. ORs were similar for glucose and A1C for primary cesarean section, preeclampsia, and preterm delivery. CONCLUSIONS: On the basis of associations with adverse outcomes, these findings suggest that A1C measurement is not a useful alternative to an OGTT in pregnant women.</abstract><cop>Alexandria, VA</cop><pub>American Diabetes Association</pub><pmid>22301123</pmid><doi>10.2337/dc11-1687</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Diabetes care, 2012-03, Vol.35 (3), p.574-580 |
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| subjects | Adult Analysis Biological and medical sciences birth weight blood glucose Blood Glucose - metabolism blood serum body fat c-peptide caregivers cesarean section Dextrose Diabetes Diabetes, Gestational - blood Diabetes. Impaired glucose tolerance Endocrine pancreas. Apud cells (diseases) Endocrinopathies fasting Female Glucose glucose tolerance Glucose Tolerance Test Glucose tolerance tests Glycated Hemoglobin A - metabolism Humans Hyperglycemia Hyperglycemia - complications Hyperglycemia - physiopathology Medical sciences Metabolic diseases Miscellaneous Original Research pre-eclampsia Pregnancy Pregnancy Outcome Pregnant women Public health. Hygiene Public health. Hygiene-occupational medicine regression analysis Womens health |
| title | Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study: Associations of maternal A1C and glucose with pregnancy outcomes |
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