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Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study: Associations of maternal A1C and glucose with pregnancy outcomes

Diabetes care, 2012-03, Vol.35 (3), p.574-580 [Peer Reviewed Journal]

2015 INIST-CNRS ;COPYRIGHT 2012 American Diabetes Association ;Copyright American Diabetes Association Mar 2012 ;2012 by the American Diabetes Association. 2012 ;ISSN: 0149-5992 ;ISSN: 1935-5548 ;EISSN: 1935-5548 ;DOI: 10.2337/dc11-1687 ;PMID: 22301123 ;CODEN: DICAD2

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Title:
Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study: Associations of maternal A1C and glucose with pregnancy outcomes
Author: 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
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 ; Medicin och hälsovetenskap ; Metabolic diseases ; Miscellaneous ; Original Research ; pre-eclampsia ; Pregnancy ; Pregnancy Outcome ; Pregnant women ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; regression analysis ; Womens health
Is Part Of: Diabetes care, 2012-03, Vol.35 (3), p.574-580
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.
Publisher: Alexandria, VA: American Diabetes Association
Language: English
Identifier: ISSN: 0149-5992
ISSN: 1935-5548
EISSN: 1935-5548
DOI: 10.2337/dc11-1687
PMID: 22301123
CODEN: DICAD2
Source: GFMER Free Medical Journals
MEDLINE
Alma/SFX Local Collection
SWEPUB Freely available online
ProQuest Central

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Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study: Associations of maternal A1C and glucose with pregnancy outcomes

2015 INIST-CNRS ;COPYRIGHT 2012 American Diabetes Association ;Copyright American Diabetes Association Mar 2012 ;2012 by the American Diabetes Association. 2012 ;ISSN: 0149-5992 ;ISSN: 1935-5548 ;EISSN: 1935-5548 ;DOI: 10.2337/dc11-1687 ;PMID: 22301123 ;CODEN: DICAD2

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