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

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 and HAPO Study Cooperative Research Group (2012) Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study: Associations of maternal A1C and glucose with pregnancy outcomes. Diabetes Care, 35 3: 574-580. doi:10.2337/dc11-1687

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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
HAPO Study Cooperative Research Group
Total Author Count Override 12
Title Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study: Associations of maternal A1C and glucose with pregnancy outcomes
Journal name Diabetes Care   Check publisher's open access policy
ISSN 0149-5992
Publication date 2012-03
Sub-type Article (original research)
DOI 10.2337/dc11-1687
Open Access Status
Volume 35
Issue 3
Start page 574
End page 580
Total pages 7
Place of publication Alexandria, VA, United States
Publisher American Diabetes Association
Collection year 2013
Language eng
Formatted 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.
Keyword Gestational diabetes-mellitus
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
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