In pregnant women without hyperglycemia in pregnancy (HIP), elevated HbA1c levels in the second or third trimester are linked to an increased risk of adverse pregnancy outcomes, suggests a recent study from China published in the journal Diabetes Research and Clinical Practice.
The aim of the study was to assess the changes in HbA1c levels during the second and third trimesters among women without hyperglycemia in pregnancy, and also to explore the association of these changes with adverse pregnancy outcomes. For this, 1057 pregnant women who delivered at a Women’s Hospital in China between May 2022 and March 2023 were enrolled for this study.
Pregnant women without hyperglycemia in pregnancy showed an overall upward trend of HbA1c levels during the second (HbA1c_S) as well as the third trimester (HbA1c_T). The results revealed a significant association between HbA1c levels and adverse pregnancy outcomes. Pregnant women with HbA1c_S < 5.5% and HbA1c_T ≥ 6.1%, or with HbA1c_S ≥ 5.5% and HbA1c_T < 6.1%, had a notable association with hypertensive disorders of pregnancy, with adjusted odds ratios (aOR) of 2.72 and 2.59, respectively.
A 1% increase in the difference in HbA1c levels between the second and third trimesters was associated with an approximately 1.96-fold increase in the risk of hypertensive disorders of pregnancy and a 1.30-fold increase in the risk of delivering a large-for-gestational-age baby.
These findings emphasize the need for strict monitoring of glucose levels during pregnancy, especially in the later stages of pregnancy, including in women without gestational diabetes. Elevated HbA1c levels in the second or third trimester should alert the treating clinician to the likelihood of adverse outcomes such as hypertensive disorders of pregnancy and large-for-gestational-age babies.
No comments:
Post a Comment