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Erschienen in: Current Diabetes Reports 1/2016

01.01.2016 | Diabetes and Pregnancy (CJ Homko, Section Editor)

Is There a Role for HbA1c in Pregnancy?

verfasst von: Ruth C. E. Hughes, Janet Rowan, Chris M. Florkowski

Erschienen in: Current Diabetes Reports | Ausgabe 1/2016

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Abstract

Outside pregnancy, HbA1c analysis is used for monitoring, screening for and diagnosing diabetes and prediabetes. During pregnancy, the role for HbA1c analysis is not yet established. Physiological changes lower HbA1c levels, and pregnancy-specific reference ranges may need to be recognised. Other factors that influence HbA1c are also important to consider, particularly since emerging data suggest that, in early pregnancy, HbA1c elevations close to the reference range may both identify women with underlying hyperglycaemia and be associated with adverse pregnancy outcomes. In later pregnancy, HbA1c analysis is less useful than an oral glucose tolerance test (OGTT) at detecting gestational diabetes. Postpartum, HbA1c analysis detects fewer women with abnormal glucose tolerance than an OGTT, but the ease of testing may improve follow-up rates and combining HbA1c analysis with fasting plasma glucose or waist circumference may improve detection rates. This article discusses the relevance of HbA1c testing at different stages of pregnancy.
Literatur
1.
Zurück zum Zitat Metzger BE, Gabbe SG, Persson B, et al. International Association of Diabetes and Pregnancy Study Groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010;33(3):676–82.CrossRefPubMed Metzger BE, Gabbe SG, Persson B, et al. International Association of Diabetes and Pregnancy Study Groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010;33(3):676–82.CrossRefPubMed
3.
4.
Zurück zum Zitat Metzger BE, Lowe LP, Dyer AR, et al. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008;358(19):1991–2002.CrossRefPubMed Metzger BE, Lowe LP, Dyer AR, et al. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008;358(19):1991–2002.CrossRefPubMed
5.
Zurück zum Zitat Jiao Y, Okumiya T, Saibara T, et al. Abnormally decreased HbA1c can be assessed with erythrocyte creatine in patients with a shortened erythrocyte age. Diabetes Care. 1998;21(10):1732–5.CrossRefPubMed Jiao Y, Okumiya T, Saibara T, et al. Abnormally decreased HbA1c can be assessed with erythrocyte creatine in patients with a shortened erythrocyte age. Diabetes Care. 1998;21(10):1732–5.CrossRefPubMed
6.
Zurück zum Zitat Lind T, Billewicz WZ, Brown G. A serial study of changes occurring in the oral glucose tolerance test during pregnancy. J Obstet Gynaecol Br Commonw. 1973;80(12):1033–9.CrossRefPubMed Lind T, Billewicz WZ, Brown G. A serial study of changes occurring in the oral glucose tolerance test during pregnancy. J Obstet Gynaecol Br Commonw. 1973;80(12):1033–9.CrossRefPubMed
7.
Zurück zum Zitat Worth R, Potter JM, Drury J. Glycosylated haemoglobin in normal pregnancy: a longitudinal study with two independent methods. Diabetologia. 1985;28(2):76–9.PubMed Worth R, Potter JM, Drury J. Glycosylated haemoglobin in normal pregnancy: a longitudinal study with two independent methods. Diabetologia. 1985;28(2):76–9.PubMed
8.
Zurück zum Zitat Ahmad J, Rafat D. HbA1c and iron deficiency: a review. Diabetes Metab Syndr. 2013;7(2):118–22.CrossRefPubMed Ahmad J, Rafat D. HbA1c and iron deficiency: a review. Diabetes Metab Syndr. 2013;7(2):118–22.CrossRefPubMed
9.
Zurück zum Zitat Coban E, Ozdogan M, Timuragaoglu A. Effect of iron deficiency anemia on the levels of hemoglobin A1c in nondiabetic patients. Acta Haematol. 2004;112(3):126–8.CrossRefPubMed Coban E, Ozdogan M, Timuragaoglu A. Effect of iron deficiency anemia on the levels of hemoglobin A1c in nondiabetic patients. Acta Haematol. 2004;112(3):126–8.CrossRefPubMed
10.
Zurück zum Zitat El-Agouza I, Abu Shahla A, Sirdah M. The effect of iron deficiency anaemia on the levels of haemoglobin subtypes: possible consequences for clinical diagnosis. Clin Lab Haematol. 2002;24(5):285–9.CrossRefPubMed El-Agouza I, Abu Shahla A, Sirdah M. The effect of iron deficiency anaemia on the levels of haemoglobin subtypes: possible consequences for clinical diagnosis. Clin Lab Haematol. 2002;24(5):285–9.CrossRefPubMed
11.•
Zurück zum Zitat Rafat D, Rabbani TK, Ahmad J, et al. Influence of iron metabolism indices on HbA1c in non-diabetic pregnant women with and without iron-deficiency anemia: effect of iron supplementation. Diabetes Metab Syndr. 2012;6(2):102–5. This study reports the changes to HbA1c levels in pregnant women associated with iron deficiency and subsequent iron replacement.CrossRefPubMed Rafat D, Rabbani TK, Ahmad J, et al. Influence of iron metabolism indices on HbA1c in non-diabetic pregnant women with and without iron-deficiency anemia: effect of iron supplementation. Diabetes Metab Syndr. 2012;6(2):102–5. This study reports the changes to HbA1c levels in pregnant women associated with iron deficiency and subsequent iron replacement.CrossRefPubMed
12.
Zurück zum Zitat Kim C, Bullard KM, Herman WH, et al. Association between iron deficiency and A1C Levels among adults without diabetes in the National Health and Nutrition Examination Survey, 1999-2006. Diabetes Care. 2010;33(4):780–5.PubMedCentralCrossRefPubMed Kim C, Bullard KM, Herman WH, et al. Association between iron deficiency and A1C Levels among adults without diabetes in the National Health and Nutrition Examination Survey, 1999-2006. Diabetes Care. 2010;33(4):780–5.PubMedCentralCrossRefPubMed
14.
Zurück zum Zitat Braatvedt G, Cundy T, Crooke M, et al. Understanding the new HbA1c units for the diagnosis of type 2 diabetes. NZ Med J. 2012;125(1362):70–80. Braatvedt G, Cundy T, Crooke M, et al. Understanding the new HbA1c units for the diagnosis of type 2 diabetes. NZ Med J. 2012;125(1362):70–80.
15.
Zurück zum Zitat Ziemer DC, Kolm P, Weintraub WS, et al. Glucose-independent, black-white differences in hemoglobin A1c levels: a cross-sectional analysis of 2 studies. Ann Intern Med. 2010;152(12):770–7.CrossRefPubMed Ziemer DC, Kolm P, Weintraub WS, et al. Glucose-independent, black-white differences in hemoglobin A1c levels: a cross-sectional analysis of 2 studies. Ann Intern Med. 2010;152(12):770–7.CrossRefPubMed
16.
Zurück zum Zitat Herman WH, Ma Y, Uwaifo G, et al. Differences in A1C by race and ethnicity among patients with impaired glucose tolerance in the Diabetes Prevention Program. Diabetes Care. 2007;30(10):2453–7.PubMedCentralCrossRefPubMed Herman WH, Ma Y, Uwaifo G, et al. Differences in A1C by race and ethnicity among patients with impaired glucose tolerance in the Diabetes Prevention Program. Diabetes Care. 2007;30(10):2453–7.PubMedCentralCrossRefPubMed
17.
Zurück zum Zitat Likhari T, Gama R. Glycaemia-independent ethnic differences in HbA(1c) in subjects with impaired glucose tolerance. Diabet Med. 2009;26(10):1068–9.CrossRefPubMed Likhari T, Gama R. Glycaemia-independent ethnic differences in HbA(1c) in subjects with impaired glucose tolerance. Diabet Med. 2009;26(10):1068–9.CrossRefPubMed
18.
Zurück zum Zitat Mostafa SA, Davies MJ, Webb DR, et al. Independent effect of ethnicity on glycemia in South Asians and white Europeans. Diabetes Care. 2012;35(8):1746–8.PubMedCentralCrossRefPubMed Mostafa SA, Davies MJ, Webb DR, et al. Independent effect of ethnicity on glycemia in South Asians and white Europeans. Diabetes Care. 2012;35(8):1746–8.PubMedCentralCrossRefPubMed
19.
Zurück zum Zitat Florkowski C. HbA1c as a diagnostic test for diabetes mellitus—reviewing the evidence. Clin Biochem Rev. 2013;34:75–83.PubMedCentralPubMed Florkowski C. HbA1c as a diagnostic test for diabetes mellitus—reviewing the evidence. Clin Biochem Rev. 2013;34:75–83.PubMedCentralPubMed
20.
Zurück zum Zitat Versantvoort AR, van Roosmalen J, Radder JK. Course of HbA1c in non-diabetic pregnancy related to birth weight. Neth J Med. 2013;71(1):22–5.PubMed Versantvoort AR, van Roosmalen J, Radder JK. Course of HbA1c in non-diabetic pregnancy related to birth weight. Neth J Med. 2013;71(1):22–5.PubMed
21.
Zurück zum Zitat O’Shea P, O’Connor C, Owens L, et al. Trimester-specific reference intervals for IFCC standardised haemoglobin A(1c): new criterion to diagnose gestational diabetes mellitus (GDM)? Ir Med J. 2012;105(5 Suppl):29–31.PubMed O’Shea P, O’Connor C, Owens L, et al. Trimester-specific reference intervals for IFCC standardised haemoglobin A(1c): new criterion to diagnose gestational diabetes mellitus (GDM)? Ir Med J. 2012;105(5 Suppl):29–31.PubMed
22.
Zurück zum Zitat Hiramatsu Y, Shimizu I, Omori Y, et al. Determination of reference intervals of glycated albumin and hemoglobin A1c in healthy pregnant Japanese women and analysis of their time courses and influencing factors during pregnancy. Endocr J. 2012;59(2):145–51.CrossRefPubMed Hiramatsu Y, Shimizu I, Omori Y, et al. Determination of reference intervals of glycated albumin and hemoglobin A1c in healthy pregnant Japanese women and analysis of their time courses and influencing factors during pregnancy. Endocr J. 2012;59(2):145–51.CrossRefPubMed
23.
Zurück zum Zitat Mosca A, Paleari R, Dalfra MG, et al. Reference intervals for hemoglobin Alc in pregnant women: data from an Italian multicenter study. Clin Chem. 2006;52(6):1138–43.CrossRefPubMed Mosca A, Paleari R, Dalfra MG, et al. Reference intervals for hemoglobin Alc in pregnant women: data from an Italian multicenter study. Clin Chem. 2006;52(6):1138–43.CrossRefPubMed
24.
Zurück zum Zitat Radder JK, van Roosmalen J. HbAIC in healthy, pregnant women. Neth J Med. 2005;63(7):256–9.PubMed Radder JK, van Roosmalen J. HbAIC in healthy, pregnant women. Neth J Med. 2005;63(7):256–9.PubMed
25.
Zurück zum Zitat Nielsen L, Ekbom P, Damm P, et al. HbA1c levels are significantly lower in early and late pregnancy. Diabetes Care. 2004;27(5):1200–1.CrossRefPubMed Nielsen L, Ekbom P, Damm P, et al. HbA1c levels are significantly lower in early and late pregnancy. Diabetes Care. 2004;27(5):1200–1.CrossRefPubMed
26.
Zurück zum Zitat O’Kane MJ, Lynch PLM, Moles KW, et al. Determination of a diabetes control and complications trial-aligned HbA1c reference range in pregnancy. Clin Chim Acta. 2001;311(2):157–9.CrossRefPubMed O’Kane MJ, Lynch PLM, Moles KW, et al. Determination of a diabetes control and complications trial-aligned HbA1c reference range in pregnancy. Clin Chim Acta. 2001;311(2):157–9.CrossRefPubMed
28.
Zurück zum Zitat Temple R, Aldridge V, Greenwood R, et al. Association between outcomes of pregnancy and glycaemic control in early pregnancy in type 1 diabetes: population based study. BMJ. 2002;325(7375):1275–6.PubMedCentralCrossRefPubMed Temple R, Aldridge V, Greenwood R, et al. Association between outcomes of pregnancy and glycaemic control in early pregnancy in type 1 diabetes: population based study. BMJ. 2002;325(7375):1275–6.PubMedCentralCrossRefPubMed
29.
Zurück zum Zitat Dunne FP, Avalos G, Durkan M, et al. ATLANTIC DIP: pregnancy outcome for women with pregestational diabetes along the Irish Atlantic seaboard. Diabetes Care. 2009;32(7):1205–6.PubMedCentralCrossRefPubMed Dunne FP, Avalos G, Durkan M, et al. ATLANTIC DIP: pregnancy outcome for women with pregestational diabetes along the Irish Atlantic seaboard. Diabetes Care. 2009;32(7):1205–6.PubMedCentralCrossRefPubMed
30.
Zurück zum Zitat Jensen DM, Korsholm L, Ovesen P, et al. Peri-conceptional A1C and risk of serious adverse pregnancy outcome in 933 women with type 1 diabetes. Diabetes Care. 2009;32(6):1046–8.PubMedCentralCrossRefPubMed Jensen DM, Korsholm L, Ovesen P, et al. Peri-conceptional A1C and risk of serious adverse pregnancy outcome in 933 women with type 1 diabetes. Diabetes Care. 2009;32(6):1046–8.PubMedCentralCrossRefPubMed
31.
Zurück zum Zitat Murphy HR, Steel SA, Roland JM, et al. Obstetric and perinatal outcomes in pregnancies complicated by type 1 and type 2 diabetes: influences of glycaemic control, obesity and social disadvantage. Diabet Med. 2011;28(9):1060–7.PubMedCentralCrossRefPubMed Murphy HR, Steel SA, Roland JM, et al. Obstetric and perinatal outcomes in pregnancies complicated by type 1 and type 2 diabetes: influences of glycaemic control, obesity and social disadvantage. Diabet Med. 2011;28(9):1060–7.PubMedCentralCrossRefPubMed
32.
Zurück zum Zitat Tennant PW, Glinianaia SV, Bilous RW, et al. Pre-existing diabetes, maternal glycated haemoglobin, and the risks of fetal and infant death: a population-based study. Diabetologia. 2014;57(2):285–94.CrossRefPubMed Tennant PW, Glinianaia SV, Bilous RW, et al. Pre-existing diabetes, maternal glycated haemoglobin, and the risks of fetal and infant death: a population-based study. Diabetologia. 2014;57(2):285–94.CrossRefPubMed
33.
Zurück zum Zitat Cundy T, Gamble G, Neale L, et al. Differing causes of pregnancy loss in type 1 and type 2 diabetes. Diabetes Care. 2007;30(10):2603–7.CrossRefPubMed Cundy T, Gamble G, Neale L, et al. Differing causes of pregnancy loss in type 1 and type 2 diabetes. Diabetes Care. 2007;30(10):2603–7.CrossRefPubMed
34.
Zurück zum Zitat Balsells M, Garcia-Patterson A, Gich I, et al. Maternal and fetal outcome in women with type 2 versus type 1 diabetes mellitus: a systematic review and metaanalysis. J Clin Endocrinol Metab. 2009;94(11):4284–91.CrossRefPubMed Balsells M, Garcia-Patterson A, Gich I, et al. Maternal and fetal outcome in women with type 2 versus type 1 diabetes mellitus: a systematic review and metaanalysis. J Clin Endocrinol Metab. 2009;94(11):4284–91.CrossRefPubMed
35.
Zurück zum Zitat Guerin A, Nisenbaum R, Ray JG. Use of maternal GHb concentration to estimate the risk of congenital anomalies in the offspring of women with prepregnancy diabetes. Diabetes Care. 2007;30(7):1920–5.CrossRefPubMed Guerin A, Nisenbaum R, Ray JG. Use of maternal GHb concentration to estimate the risk of congenital anomalies in the offspring of women with prepregnancy diabetes. Diabetes Care. 2007;30(7):1920–5.CrossRefPubMed
36.•
Zurück zum Zitat Bell R, Glinianaia S, Tennant PWG, Bilous R, Rankin J. Peri-conception hyperglycaemia and nephropathy are associated with risk of congenital anomaly in women with pre-existing diabetes: a population-based cohort study. Diabetologia. 2012;55(4):936–947. This study reports useful data for clinicians to accurately give advice about risk of anomaly to women with pre-existing diabetes. Bell R, Glinianaia S, Tennant PWG, Bilous R, Rankin J. Peri-conception hyperglycaemia and nephropathy are associated with risk of congenital anomaly in women with pre-existing diabetes: a population-based cohort study. Diabetologia. 2012;55(4):936–947. This study reports useful data for clinicians to accurately give advice about risk of anomaly to women with pre-existing diabetes.
37.•
Zurück zum Zitat Hughes RC, Moore MP, Gullam JE, et al. An early pregnancy HbA1c >/=5.9% (41 mmol/mol) is optimal for detecting diabetes and identifies women at increased risk of adverse pregnancy outcomes. Diabetes Care. 2014;37(11):2953–9. This study defines a useful pregnancy HbA1c threshold to identify women with pre-existing but undiagnosed diabetes. It also shows that this HbA1c threshold is a marker for adverse pregnancy outcomes such as congenital anomalies, preterm delivery, pre-eclampsia, shoulder dystocia and possibly peri-natal death.CrossRefPubMed Hughes RC, Moore MP, Gullam JE, et al. An early pregnancy HbA1c >/=5.9% (41 mmol/mol) is optimal for detecting diabetes and identifies women at increased risk of adverse pregnancy outcomes. Diabetes Care. 2014;37(11):2953–9. This study defines a useful pregnancy HbA1c threshold to identify women with pre-existing but undiagnosed diabetes. It also shows that this HbA1c threshold is a marker for adverse pregnancy outcomes such as congenital anomalies, preterm delivery, pre-eclampsia, shoulder dystocia and possibly peri-natal death.CrossRefPubMed
38.•
Zurück zum Zitat Glinianaia SV, Tennant PW, Bilous RW, et al. HbA(1c) and birthweight in women with pre-conception type 1 and type 2 diabetes: a population-based cohort study. Diabetologia. 2012;55(12):3193–203. This study shows the influence of hyperglycaemia on fetal growth and important interactions between early and later HbA1c measures.CrossRefPubMed Glinianaia SV, Tennant PW, Bilous RW, et al. HbA(1c) and birthweight in women with pre-conception type 1 and type 2 diabetes: a population-based cohort study. Diabetologia. 2012;55(12):3193–203. This study shows the influence of hyperglycaemia on fetal growth and important interactions between early and later HbA1c measures.CrossRefPubMed
39.
Zurück zum Zitat Vambergue A, Fajardy I. Consequences of gestational and pregestational diabetes on placental function and birth weight. World J Diabetes. 2011;2(11):196–203.PubMedCentralPubMed Vambergue A, Fajardy I. Consequences of gestational and pregestational diabetes on placental function and birth weight. World J Diabetes. 2011;2(11):196–203.PubMedCentralPubMed
40.
Zurück zum Zitat Holmes VA, Young IS, Patterson CC, et al. Optimal glycemic control, pre-eclampsia, and gestational hypertension in women with type 1 diabetes in the diabetes and pre-eclampsia intervention trial. Diabetes Care. 2011;34(8):1683–8.PubMedCentralCrossRefPubMed Holmes VA, Young IS, Patterson CC, et al. Optimal glycemic control, pre-eclampsia, and gestational hypertension in women with type 1 diabetes in the diabetes and pre-eclampsia intervention trial. Diabetes Care. 2011;34(8):1683–8.PubMedCentralCrossRefPubMed
41.
Zurück zum Zitat Damm P, Mersebach H, Rastam J, et al. Poor pregnancy outcome in women with type 1 diabetes is predicted by elevated HbA1c and spikes of high glucose values in the third trimester. J Matern Fetal Neonatal Med. 2014;27(2):149–54.PubMedCentralCrossRefPubMed Damm P, Mersebach H, Rastam J, et al. Poor pregnancy outcome in women with type 1 diabetes is predicted by elevated HbA1c and spikes of high glucose values in the third trimester. J Matern Fetal Neonatal Med. 2014;27(2):149–54.PubMedCentralCrossRefPubMed
42.
Zurück zum Zitat Evers IM, de Valk HW, Mol BW, et al. Macrosomia despite good glycaemic control in type I diabetic pregnancy; results of a nationwide study in The Netherlands. Diabetologia. 2002;45(11):1484–9.CrossRefPubMed Evers IM, de Valk HW, Mol BW, et al. Macrosomia despite good glycaemic control in type I diabetic pregnancy; results of a nationwide study in The Netherlands. Diabetologia. 2002;45(11):1484–9.CrossRefPubMed
43.
Zurück zum Zitat Kerssen A, de Valk HW, Visser GH. Increased second trimester maternal glucose levels are related to extremely large-for-gestational-age infants in women with type 1 diabetes. Diabetes Care. 2007;30(5):1069–74.CrossRefPubMed Kerssen A, de Valk HW, Visser GH. Increased second trimester maternal glucose levels are related to extremely large-for-gestational-age infants in women with type 1 diabetes. Diabetes Care. 2007;30(5):1069–74.CrossRefPubMed
44.
Zurück zum Zitat Penney GC, Mair G, Pearson DW. The relationship between birth weight and maternal glycated haemoglobin (HbA1c) concentration in pregnancies complicated by type 1 diabetes. Diabet Med. 2003;20(2):162–6.CrossRefPubMed Penney GC, Mair G, Pearson DW. The relationship between birth weight and maternal glycated haemoglobin (HbA1c) concentration in pregnancies complicated by type 1 diabetes. Diabet Med. 2003;20(2):162–6.CrossRefPubMed
45.•
Zurück zum Zitat Maresh MJ, Holmes VA, Patterson CC, et al. Glycemic targets in the second and third trimester of pregnancy for women with type 1 diabetes. Diabetes Care. 2015;38(1):34–42. Useful data to recommend that HbA1c <42 mmol/mol (6.0%) through pregnancy should be the target in women with pre-existing diabetes.CrossRefPubMed Maresh MJ, Holmes VA, Patterson CC, et al. Glycemic targets in the second and third trimester of pregnancy for women with type 1 diabetes. Diabetes Care. 2015;38(1):34–42. Useful data to recommend that HbA1c <42 mmol/mol (6.0%) through pregnancy should be the target in women with pre-existing diabetes.CrossRefPubMed
46.
Zurück zum Zitat Capula C, Mazza T, Vero R, et al. HbA1c levels in patients with gestational diabetes mellitus: relationship with pre-pregnancy BMI and pregnancy outcome. J Endocrinol Investig. 2013;36(11):1038–45. Capula C, Mazza T, Vero R, et al. HbA1c levels in patients with gestational diabetes mellitus: relationship with pre-pregnancy BMI and pregnancy outcome. J Endocrinol Investig. 2013;36(11):1038–45.
47.
Zurück zum Zitat Barnes RA, Edghill N, Mackenzie J, et al. Predictors of large and small for gestational age birthweight in offspring of women with gestational diabetes mellitus. Diabet Med. 2013;30(9):1040–6.CrossRefPubMed Barnes RA, Edghill N, Mackenzie J, et al. Predictors of large and small for gestational age birthweight in offspring of women with gestational diabetes mellitus. Diabet Med. 2013;30(9):1040–6.CrossRefPubMed
48.
Zurück zum Zitat Rowan JA, Gao W, Hague WM, et al. Glycemia and its relationship to outcomes in the metformin in gestational diabetes trial. Diabetes Care. 2010;33(1):9–16.PubMedCentralCrossRefPubMed Rowan JA, Gao W, Hague WM, et al. Glycemia and its relationship to outcomes in the metformin in gestational diabetes trial. Diabetes Care. 2010;33(1):9–16.PubMedCentralCrossRefPubMed
49.
Zurück zum Zitat Katon J, Reiber G, Williams MA, et al. Antenatal haemoglobin A1c and risk of large-for-gestational-age infants in a multi-ethnic cohort of women with gestational diabetes. Paediatr Perinat Epidemiol. 2012;26(3):208–17.CrossRefPubMed Katon J, Reiber G, Williams MA, et al. Antenatal haemoglobin A1c and risk of large-for-gestational-age infants in a multi-ethnic cohort of women with gestational diabetes. Paediatr Perinat Epidemiol. 2012;26(3):208–17.CrossRefPubMed
50.
Zurück zum Zitat Barrett H, Nitert MD, McIntyre HD, et al. Predictors of preeclampsia in women in the Metformin in Gestational Diabetes (Mig) Study. J Diabetes Metab. 2014;5(7):395.CrossRef Barrett H, Nitert MD, McIntyre HD, et al. Predictors of preeclampsia in women in the Metformin in Gestational Diabetes (Mig) Study. J Diabetes Metab. 2014;5(7):395.CrossRef
51.
Zurück zum Zitat Crowther C, Hiller J, Moss J, et al. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med. 2005;352:2477–86.CrossRefPubMed Crowther C, Hiller J, Moss J, et al. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med. 2005;352:2477–86.CrossRefPubMed
52.
Zurück zum Zitat Landon MB, Spong CY, Thom E, et al. A multicenter, randomized trial of treatment for mild gestational diabetes. N Engl J Med. 2009;361(14):1339–48.PubMedCentralCrossRefPubMed Landon MB, Spong CY, Thom E, et al. A multicenter, randomized trial of treatment for mild gestational diabetes. N Engl J Med. 2009;361(14):1339–48.PubMedCentralCrossRefPubMed
53.
Zurück zum Zitat Karcaaltincaba D, Yalvac S, Kandemir O, et al. Glycosylated hemoglobin level in the second trimester predicts birth weight and amniotic fluid volume in non-diabetic pregnancies with abnormal screening test. J Matern Fetal Neonatal Med. 2010;23(10):1193–9.CrossRefPubMed Karcaaltincaba D, Yalvac S, Kandemir O, et al. Glycosylated hemoglobin level in the second trimester predicts birth weight and amniotic fluid volume in non-diabetic pregnancies with abnormal screening test. J Matern Fetal Neonatal Med. 2010;23(10):1193–9.CrossRefPubMed
54.
Zurück zum Zitat Nayak AU, Duff CJ, Indusekhar R, et al. Adverse foetal outcomes in women at risk of gestational diabetes with normal OGTT: exploring the role of HbA1c in risk prediction. In: 50th Annual Meeting of the European Association for the Study of Diabetes, EASD 2014: 15-19th Sept 2014; Vienna. Diabetologia. 2014;57(Suppl 1): S447, Abstract 1088. Nayak AU, Duff CJ, Indusekhar R, et al. Adverse foetal outcomes in women at risk of gestational diabetes with normal OGTT: exploring the role of HbA1c in risk prediction. In: 50th Annual Meeting of the European Association for the Study of Diabetes, EASD 2014: 15-19th Sept 2014; Vienna. Diabetologia. 2014;57(Suppl 1): S447, Abstract 1088.
55.
Zurück zum Zitat Ensenauer R, Gmach J, Nehring I, et al. Increased hemoglobin A(1c) in obese pregnant women after exclusion of gestational diabetes. Clin Chem. 2012;58(7):1152–4.CrossRefPubMed Ensenauer R, Gmach J, Nehring I, et al. Increased hemoglobin A(1c) in obese pregnant women after exclusion of gestational diabetes. Clin Chem. 2012;58(7):1152–4.CrossRefPubMed
56.•
Zurück zum Zitat Alunni ML, Roeder HA, Moore TR, et al. First trimester gestational diabetes screening—change in incidence and pharmacotherapy need. Diabetes Res Clin Pract. 2015;109(1):135–40. A retrospective report of first trimester diabetes screening with HbA1c and FPG in a large cohort of women in California.CrossRefPubMed Alunni ML, Roeder HA, Moore TR, et al. First trimester gestational diabetes screening—change in incidence and pharmacotherapy need. Diabetes Res Clin Pract. 2015;109(1):135–40. A retrospective report of first trimester diabetes screening with HbA1c and FPG in a large cohort of women in California.CrossRefPubMed
57.
Zurück zum Zitat McGrath NM, Baker C, Simkins A. Increased detection of gestational diabetes mellitus by using HbA screening in the first antenatal blood tests. Diabet Med. 2014;31(10):1277. McGrath NM, Baker C, Simkins A. Increased detection of gestational diabetes mellitus by using HbA screening in the first antenatal blood tests. Diabet Med. 2014;31(10):1277.
58.•
Zurück zum Zitat Rowan JA, Budden A, Sadler LC. Women with a nondiagnostic 75 g glucose tolerance test but elevated HbA1c in pregnancy: an additional group of women with gestational diabetes. Aust N Z J Obstet Gynaecol. 2014;54(2):177–80. A small study, but it demonstrates that an HbA1c threshold ≥41mmol/mol (5.9%) identifies women with hyperglycaemia in pregnancy and therefore may be considered as an adjunct test for GDM in women with a non-diagnostic OGTT, but where there is high clinical suspicion (eg obese woman with macrosomic fetus).CrossRefPubMed Rowan JA, Budden A, Sadler LC. Women with a nondiagnostic 75 g glucose tolerance test but elevated HbA1c in pregnancy: an additional group of women with gestational diabetes. Aust N Z J Obstet Gynaecol. 2014;54(2):177–80. A small study, but it demonstrates that an HbA1c threshold ≥41mmol/mol (5.9%) identifies women with hyperglycaemia in pregnancy and therefore may be considered as an adjunct test for GDM in women with a non-diagnostic OGTT, but where there is high clinical suspicion (eg obese woman with macrosomic fetus).CrossRefPubMed
59.
Zurück zum Zitat Rowan JA, Budden A, Ivanova V, et al. Women with an HbA of 41-49 mmol/mol (5.9-6.6%): a higher risk subgroup that may benefit from early pregnancy intervention. Diabet Med. 2015;33(1):25–31. Rowan JA, Budden A, Ivanova V, et al. Women with an HbA of 41-49 mmol/mol (5.9-6.6%): a higher risk subgroup that may benefit from early pregnancy intervention. Diabet Med. 2015;33(1):25–31.
60.
Zurück zum Zitat Osmundson S, Norton M, El-Sayed Y, et al. Early treatment of women with prediabetes in pregnancy: a randomized controlled trial. In: 35th Annual Meeting of the Society for Maternal-Fetal Medicine: The Pregnancy Meeting.: 02-07 Feb 2015; San Diego. Am J Obstet Gynecol. 2015;212(1): S23-S24, abstract 35. Osmundson S, Norton M, El-Sayed Y, et al. Early treatment of women with prediabetes in pregnancy: a randomized controlled trial. In: 35th Annual Meeting of the Society for Maternal-Fetal Medicine: The Pregnancy Meeting.: 02-07 Feb 2015; San Diego. Am J Obstet Gynecol. 2015;212(1): S23-S24, abstract 35.
61.
Zurück zum Zitat Lowe LP, Metzger BE, Dyer AR, et al. Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study: associations of maternal A1C and glucose with pregnancy outcomes. Diabetes Care. 2012;35(3):574–80.PubMedCentralCrossRefPubMed Lowe LP, Metzger BE, Dyer AR, et al. Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study: associations of maternal A1C and glucose with pregnancy outcomes. Diabetes Care. 2012;35(3):574–80.PubMedCentralCrossRefPubMed
62.
Zurück zum Zitat Fong A, Serra AE, Gabby L, et al. Use of hemoglobin A1c as an early predictor of gestational diabetes mellitus. Am J Obstet Gynecol. 2014;211(6):641 e1–e7.CrossRefPubMed Fong A, Serra AE, Gabby L, et al. Use of hemoglobin A1c as an early predictor of gestational diabetes mellitus. Am J Obstet Gynecol. 2014;211(6):641 e1–e7.CrossRefPubMed
63.
Zurück zum Zitat Balaji V, Madhuri BS, Ashalatha S, et al. A1C in gestational diabetes mellitus in Asian Indian women. Diabetes Care. 2007;30(7):1865–7.CrossRefPubMed Balaji V, Madhuri BS, Ashalatha S, et al. A1C in gestational diabetes mellitus in Asian Indian women. Diabetes Care. 2007;30(7):1865–7.CrossRefPubMed
64.
Zurück zum Zitat Anaka O, Houlihan C, Beim R, et al. Does first-trimester hemoglobin A1C predict gestational diabetes and fetal outcome? In: 62nd Annual Clinical Meeting of the American College of Obstetricians and Gynecologists: 26-30th April 2014; Chicago. Obstet Gynecol. 2014;123 (Suppl 1): 38S-39S. Anaka O, Houlihan C, Beim R, et al. Does first-trimester hemoglobin A1C predict gestational diabetes and fetal outcome? In: 62nd Annual Clinical Meeting of the American College of Obstetricians and Gynecologists: 26-30th April 2014; Chicago. Obstet Gynecol. 2014;123 (Suppl 1): 38S-39S.
65.
Zurück zum Zitat Willems D, Moreno YBL, Barglazan D, et al. HbA1c and screening of gestational diabetes. In: EuroMedLab: 21-25th June 2015; Paris. Clin Chem Lab Med. 2015;53(Special Suppl): S664, Abstract T065. Willems D, Moreno YBL, Barglazan D, et al. HbA1c and screening of gestational diabetes. In: EuroMedLab: 21-25th June 2015; Paris. Clin Chem Lab Med. 2015;53(Special Suppl): S664, Abstract T065.
66.
Zurück zum Zitat Berggren E, Boggess K, Mathew L, et al. First trimester HbA1c, at clinically normal values, may be an early predictor of third trimester gestational diabetes. In: 35th Annual Meeting of the Society for Maternal-Fetal Medicine: The Pregnancy Meeting.: 02-07 Feb 2015; San Diego. Am J Obstet Gynecol. 2015;212(1): S168-S169, Abstract 312. Berggren E, Boggess K, Mathew L, et al. First trimester HbA1c, at clinically normal values, may be an early predictor of third trimester gestational diabetes. In: 35th Annual Meeting of the Society for Maternal-Fetal Medicine: The Pregnancy Meeting.: 02-07 Feb 2015; San Diego. Am J Obstet Gynecol. 2015;212(1): S168-S169, Abstract 312.
67.
Zurück zum Zitat Sevket O, Sevket A, Ozel A, et al. The use of HbA1c as an aid in the diagnosis of gestational diabetes mellitus. J Obstet Gynaecol Br Commonw. 2014;34(8):690–2.CrossRef Sevket O, Sevket A, Ozel A, et al. The use of HbA1c as an aid in the diagnosis of gestational diabetes mellitus. J Obstet Gynaecol Br Commonw. 2014;34(8):690–2.CrossRef
68.
Zurück zum Zitat Rajput R, Yogesh Y, Rajput M, et al. Utility of HbA1c for diagnosis of gestational diabetes mellitus. Diabetes Res Clin Pract. 2012;98(1):104–7.CrossRefPubMed Rajput R, Yogesh Y, Rajput M, et al. Utility of HbA1c for diagnosis of gestational diabetes mellitus. Diabetes Res Clin Pract. 2012;98(1):104–7.CrossRefPubMed
69.
Zurück zum Zitat Sugiyama T, Saito M, Nishigori H, et al. Comparison of pregnancy outcomes between women with gestational diabetes and overt diabetes first diagnosed in pregnancy: a retrospective multi-institutional study in Japan. Diabetes Res Clin Pract. 2014;103(1):20–5.CrossRefPubMed Sugiyama T, Saito M, Nishigori H, et al. Comparison of pregnancy outcomes between women with gestational diabetes and overt diabetes first diagnosed in pregnancy: a retrospective multi-institutional study in Japan. Diabetes Res Clin Pract. 2014;103(1):20–5.CrossRefPubMed
70.
Zurück zum Zitat Agarwal M, Dhatt G, Punnose J, et al. Gestational diabetes: a reappraisal of HbA1c as a screening test. Acta Obstet Gynecol Scand. 2005;84(12):1159–63.CrossRefPubMed Agarwal M, Dhatt G, Punnose J, et al. Gestational diabetes: a reappraisal of HbA1c as a screening test. Acta Obstet Gynecol Scand. 2005;84(12):1159–63.CrossRefPubMed
71.
Zurück zum Zitat Bellamy L, Casas JP, Hingorani AD, et al. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet. 2009;373(9677):1773–9.CrossRefPubMed Bellamy L, Casas JP, Hingorani AD, et al. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet. 2009;373(9677):1773–9.CrossRefPubMed
72.
Zurück zum Zitat Keely E. An opportunity not to be missed—how do we improve postpartum screening rates for women with gestational diabetes? Diabetes Metab Res Rev. 2012;28(4):312–6.CrossRefPubMed Keely E. An opportunity not to be missed—how do we improve postpartum screening rates for women with gestational diabetes? Diabetes Metab Res Rev. 2012;28(4):312–6.CrossRefPubMed
73.
Zurück zum Zitat Benaiges D, Chillaron JJ, Pedro-Botet J, et al. Role of A1c in the postpartum screening of women with gestational diabetes. Gynecol Endocrinol. 2013;29(7):687–90.CrossRefPubMed Benaiges D, Chillaron JJ, Pedro-Botet J, et al. Role of A1c in the postpartum screening of women with gestational diabetes. Gynecol Endocrinol. 2013;29(7):687–90.CrossRefPubMed
74.
Zurück zum Zitat Picon MJ, Murri M, Munoz A, et al. Hemoglobin A1c versus oral glucose tolerance test in postpartum diabetes screening. Diabetes Care. 2012;35(8):1648–53.PubMedCentralCrossRefPubMed Picon MJ, Murri M, Munoz A, et al. Hemoglobin A1c versus oral glucose tolerance test in postpartum diabetes screening. Diabetes Care. 2012;35(8):1648–53.PubMedCentralCrossRefPubMed
75.
Zurück zum Zitat Shah BR, Lipscombe LL, Feig DS, et al. Missed opportunities for type 2 diabetes testing following gestational diabetes: a population-based cohort study. Br J Obstet Gynaecol. 2011;118(12):1484–90.CrossRef Shah BR, Lipscombe LL, Feig DS, et al. Missed opportunities for type 2 diabetes testing following gestational diabetes: a population-based cohort study. Br J Obstet Gynaecol. 2011;118(12):1484–90.CrossRef
76.
Zurück zum Zitat McGrath NM, Coats A, Barach O. Improved post-partum follow-up of patients with gestational diabetes mellitus using HbA1c. Diabet Med. 2013;30(10):1264–5.CrossRefPubMed McGrath NM, Coats A, Barach O. Improved post-partum follow-up of patients with gestational diabetes mellitus using HbA1c. Diabet Med. 2013;30(10):1264–5.CrossRefPubMed
77.
Zurück zum Zitat Megia A, Naf S, Herranz L, et al. The usefulness of HbA1c in postpartum reclassification of gestational diabetes. Br J Obstet Gynaecol. 2012;119(7):891–4.CrossRef Megia A, Naf S, Herranz L, et al. The usefulness of HbA1c in postpartum reclassification of gestational diabetes. Br J Obstet Gynaecol. 2012;119(7):891–4.CrossRef
78.
Zurück zum Zitat Kim C, Herman WH, Cheung NW, et al. Comparison of hemoglobin A1c with fasting plasma glucose and 2-h postchallenge glucose for risk stratification among women with recent gestational diabetes mellitus. Diabetes Care. 2011;34(9):1949–51.PubMedCentralCrossRefPubMed Kim C, Herman WH, Cheung NW, et al. Comparison of hemoglobin A1c with fasting plasma glucose and 2-h postchallenge glucose for risk stratification among women with recent gestational diabetes mellitus. Diabetes Care. 2011;34(9):1949–51.PubMedCentralCrossRefPubMed
79.
Zurück zum Zitat Su X, Zhang Z, Qu X, et al. Hemoglobin A1c for diagnosis of postpartum abnormal glucose tolerance among women with gestational diabetes mellitus: diagnostic meta-analysis. PLoS One. 2014;9(7):e102144.PubMedCentralCrossRefPubMed Su X, Zhang Z, Qu X, et al. Hemoglobin A1c for diagnosis of postpartum abnormal glucose tolerance among women with gestational diabetes mellitus: diagnostic meta-analysis. PLoS One. 2014;9(7):e102144.PubMedCentralCrossRefPubMed
80.
Zurück zum Zitat Noctor E, Crowe C, Carmody LA, et al. ATLANTIC DIP: simplifying the follow-up of women with previous gestational diabetes. Eur J Endocrinol. 2013;169(5):681–7.CrossRefPubMed Noctor E, Crowe C, Carmody LA, et al. ATLANTIC DIP: simplifying the follow-up of women with previous gestational diabetes. Eur J Endocrinol. 2013;169(5):681–7.CrossRefPubMed
81.•
Zurück zum Zitat Gobl CS, Bozkurt L, Yarragudi R, et al. Is early postpartum HbA1c an appropriate risk predictor after pregnancy with gestational diabetes mellitus? Acta Diabetol. 2014;51(5):715–722. This paper includes an excellent discussion on the usefulness of postpartum HbA1c analysis, suggesting that serial measures of HbA1c are more useful than a single postnatal test. Gobl CS, Bozkurt L, Yarragudi R, et al. Is early postpartum HbA1c an appropriate risk predictor after pregnancy with gestational diabetes mellitus? Acta Diabetol. 2014;51(5):715–722. This paper includes an excellent discussion on the usefulness of postpartum HbA1c analysis, suggesting that serial measures of HbA1c are more useful than a single postnatal test.
82.
Zurück zum Zitat Claesson R, Ekelund M, Ignell C, et al. Role of HbA1c in post-partum screening of women with gestational diabetes mellitus. J Clin Translational Endocrinol. 2015;2(1):21–5.CrossRef Claesson R, Ekelund M, Ignell C, et al. Role of HbA1c in post-partum screening of women with gestational diabetes mellitus. J Clin Translational Endocrinol. 2015;2(1):21–5.CrossRef
83.
Zurück zum Zitat Gingras V, Tchernof A, Weisnagel SJ, et al. Use of glycated hemoglobin and waist circumference for diabetic screening in women with a history of gestational diabetes. J Obstet Gynaecol Can. 2013;35(9):810–5.CrossRefPubMed Gingras V, Tchernof A, Weisnagel SJ, et al. Use of glycated hemoglobin and waist circumference for diabetic screening in women with a history of gestational diabetes. J Obstet Gynaecol Can. 2013;35(9):810–5.CrossRefPubMed
Metadaten
Titel
Is There a Role for HbA1c in Pregnancy?
verfasst von
Ruth C. E. Hughes
Janet Rowan
Chris M. Florkowski
Publikationsdatum
01.01.2016
Verlag
Springer US
Erschienen in
Current Diabetes Reports / Ausgabe 1/2016
Print ISSN: 1534-4827
Elektronische ISSN: 1539-0829
DOI
https://doi.org/10.1007/s11892-015-0698-y

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