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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

Diabetes care, 2012-03, Vol.35 (3), p.574-580 [Periódico revisado por pares]

Alexandria, VA: American Diabetes Association

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Título:
Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study: Associations of maternal A1C and glucose with pregnancy outcomes
Autor: 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
Assuntos: 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
É parte de: Diabetes care, 2012-03, Vol.35 (3), p.574-580
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
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Descrição: 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.
Editor: Alexandria, VA: American Diabetes Association
Idioma: Inglês

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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

Alexandria, VA: American Diabetes Association

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