HbA1c as a predictor of postpartum diabetes mellitus after gestational diabetes mellitus

Varejão, Ana Mesquita; Ferreira, Joana Lima; Dória, Mariana; Laranjo, Mafalda; Araújo, M. Calado; Peixinho, Catarina; Couto, Adelina Sá; Príncipe, Rosa Maria

doi:10.1016/j.dsx.2021.102269

Cited by 4 publications

(4 citation statements)

References 5 publications

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“…Although it is recommended that HbA1c levels should be controlled to <6.5%, the risk of obstetric complications increases linearly with increasing HbA1c levels during pregnancy. A previous study reported that maternal HbA1c levels were predictive of DM following GDM, among which HbA1c levels ≥5.4%, but within the normal range, were associated with a 6.1‐fold risk for postpartum DM 19 . In the present study, in a normoglycemic population (HbA1c <6.5%), high maternal HbA1c levels were closely related to the risk of macrosomia, LGA, PTB, and gestational age at delivery.…”

Section: Discussionsupporting

confidence: 63%

“…-5 of 11 maternal HbA1c levels were predictive of DM following GDM, among which HbA1c levels ≥5.4%, but within the normal range, were associated with a 6.1-fold risk for postpartum DM. 19 In the present study, in a normoglycemic population (HbA1c <6.5%), high maternal HbA1c levels were closely related to the risk of macrosomia, LGA, PTB, and gestational age at delivery. A U-shaped non-linear association was suggested for HbA1c levels in relation to PTB risk, among which PTB risk significantly increased with increasing HbA1c levels when HbA1c was >4.56%.…”

Section: Discussionsupporting

confidence: 45%

“…A series of large cohort studies, such as the Hyperglycemia and Adverse Pregnancy Outcome studies, have established an association between maternal glucose levels, newborn anthropometrics, pregnancy complications, and adverse birth outcomes 10,17–19 . Some studies have reported that blood glucose variability throughout pregnancy is closely related to the occurrence of adverse obstetric outcomes, emphasising the importance of estimating glucose levels during a specific period.…”

Section: Discussionmentioning

confidence: 99%

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Interaction effects of MTHFR C677T and A1298C polymorphisms with maternal glycated haemoglobin levels on adverse birth outcomes

Wu,

Luo,

et al. 2024

Diabetes Metabolism Res

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AimsThe role of maternal genetic factors in the association between high glycated haemoglobin (HbA1c) levels and adverse birth outcomes remains unclear.Materials and MethodsIn this study, the maternal HbA1c levels of 5108 normoglycemic pregnant women in China were measured, and A1298C and C677T polymorphisms in the methylenetetrahydrofolate reductase (MTHFR) gene were genotyped.ResultsElevated HbA1c levels during the second trimester were associated with increased risks of macrosomia, large‐for‐gestational age (LGA), preterm birth (PTB), and reduced gestational age (p < 0.05). Pregnant women with MTHFR A1298C AA or C677T CT + TT genotypes were susceptible to adverse pregnancy outcomes related to HbA1c levels. Among pregnant women with the A1298C AA genotype, each standard deviation (SD) increase in HbA1c levels increased the risk of PTB by 1.32‐times and reduced the gestational age by 0.11 weeks (p < 0.05). For MTHFR C677T CC + TT genotype carriers, higher HbA1c levels were associated with 1.49‐, 1.24‐, and 1.23‐times increased risks of macrosomia, LGA, and PTB, respectively (p < 0.05). A U‐shaped curve for PTB risk in relation to HbA1c levels was observed among the C677T CC + TT participants, with a cut‐off value of 4.58%. Among subjects with the A1298C AA genotype combined with the C677T CT + TT genotype, each SD increase in HbA1c levels was associated with 1.40 and 1.37‐times increased risks of LGA and PTB, respectively.ConclusionsOur findings highlight the importance of glycaemic control during pregnancy and the potential impact of genetic factors on birth outcomes. However, further large‐scale studies are required to confirm these findings.

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Section: Discussionsupporting

confidence: 63%

Section: Discussionsupporting

confidence: 45%

Section: Discussionmentioning

confidence: 99%

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Interaction effects of MTHFR C677T and A1298C polymorphisms with maternal glycated haemoglobin levels on adverse birth outcomes

Wu,

Luo,

et al. 2024

Diabetes Metabolism Res

View full text Add to dashboard Cite

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“…Our working hypothesis was that by undertaking comprehensive examination of metabolic profiles, in addition to traditional metabolic markers, it could be possible to elucidate the associations of circulating metabolites during pregnancy to postpartum metabolic disorders and thus to reveal potential targets for interventions. With respect to the traditional metabolic markers, high third trimester glycated hemoglobin (HbA1c) levels at least 36 mmol/mol (5.4%) have been associated with an increased risk of diabetes mellitus in women with GDM from pregnancy up to five years postpartum (Claesson et al, 2017 ; Varejão et al, 2021 ). Elevated high-sensitivity C-reactive protein (hsCRP) levels during mid-pregnancy have also been associated with dysglycemia during the first postpartum year (Durnwald et al, 2018 ; Ozuguz et al, 2011 ).…”

Section: Introductionmentioning

confidence: 99%

Aberrations in the early pregnancy serum metabolic profile in women with prediabetes at two years postpartum

et al. 2023

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Introduction Aberrations in circulating metabolites have been associated with diabetes and cardiovascular risk. Objectives To investigate if early and late pregnancy serum metabolomic profiles differ in women who develop prediabetes by two years postpartum compared to those who remain normoglycemic. Methods An NMR metabolomics platform was used to measure 228 serum metabolite variables from women with pre-pregnancy overweight in early and late pregnancy. Co-abundant groups of metabolites were compared between the women who were (n = 40) or were not (n = 138) prediabetic at two years postpartum. Random Forests classifiers, based on the metabolic profiles, were used to predict the prediabetes status, and correlations of the metabolites to glycemic traits (fasting glucose and insulin, HOMA2-IR and HbA1c) and hsCRP at postpartum were evaluated. Results Women with prediabetes had higher concentrations of small HDL particles, total lipids in small HDL, phospholipids in small HDL and free cholesterol in small HDL in early pregnancy (p = 0.029; adj with pre-pregnancy BMI p = 0.094). The small HDL related metabolites also correlated positively with markers of insulin resistance at postpartum. Similar associations were not detected for metabolites in late pregnancy. A Random Forests classifier based on serum metabolites and clinical variables in early pregnancy displayed an acceptable predictive power for the prediabetes status at postpartum (AUROC 0.668). Conclusion Elevated serum concentrations of small HDL particles in early pregnancy associate with prediabetes and insulin resistance at two years postpartum. The serum metabolic profile during pregnancy might be used to identify women at increased risk for type 2 diabetes.

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Risk factors associated with early postpartum glucose intolerance in women with a history of gestational diabetes mellitus: a systematic review and meta-analysis

Zhang

Liu

et al. 2023

Endocrine

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HbA1c as a predictor of postpartum diabetes mellitus after gestational diabetes mellitus

Cited by 4 publications

References 5 publications

Interaction effects of MTHFR C677T and A1298C polymorphisms with maternal glycated haemoglobin levels on adverse birth outcomes

Interaction effects of MTHFR C677T and A1298C polymorphisms with maternal glycated haemoglobin levels on adverse birth outcomes

Aberrations in the early pregnancy serum metabolic profile in women with prediabetes at two years postpartum

Risk factors associated with early postpartum glucose intolerance in women with a history of gestational diabetes mellitus: a systematic review and meta-analysis

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