Elevated glycated hemoglobin predicts macrosomia among Asian Indian pregnant women (WINGS-9)

Bhavadharini, B and Mahalakshmi, M and Deepa, M and Ranjani, H and Ranjit, U and Anjana, R M and Malanda, B and Kayal , A and Belton, A and Saravanan, P and Uma, R and Mohan, V (2017) Elevated glycated hemoglobin predicts macrosomia among Asian Indian pregnant women (WINGS-9). Indian Journal of Endocrinology and Metabolism, 21 (1). p. 184. ISSN 2230-8210



Aim: The aim of this study was to determine the optimal glycated hemoglobin (HbA1c) cut point for diagnosis of gestational diabetes mellitus (GDM) and to evaluate the usefulness of HbA1c as a prognostic indicator for adverse pregnancy outcomes. Methods: HbA1c estimations were carried out in 1459 pregnant women attending antenatal care centers in urban and rural Tamil Nadu in South India. An oral glucose tolerance test was carried out using 75 g anhydrous glucose, and GDM was diagnosed using the International Association of the Diabetes and Pregnancy Study Groups criteria. Results: GDM was diagnosed in 195 women. Receiver operating curves showed a HbA1c cut point of ≥ 5.0% (≥31 mmol/mol) have a sensitivity of 66.2% and specificity of 56.2% for identifying GDM (area under the curve 0.679, confidence interval [CI]: 0.655–0.703). Women with HbA1c ≥ 5.0% (≥31 mmol/mol) were significantly older and had higher body mass index, greater history of previous GDM, and a higher prevalence of macrosomia compared to women with HbA1c < 5.0% (<31 mmol/mol). The adjusted odds ratio for macrosomia in those with HbA1c ≥ 5.0% (≥31 mmol/mol) was 1.92 (CI: 1.24–2.97, P = 0.003). However, other pregnancy outcomes were not significantly different. Conclusion: In Asian Indian pregnant women, a HbA1c of 5.0% (31 mmol/mol) or greater is associated with increased risk of macrosomia.

Item Type:Article
Official URL/DOI:http://dx.doi.org/10.4103/2230-8210.196003
Uncontrolled Keywords:Adverse pregnancy outcomes, Asian Indians, glycated hemoglobin, macrosomia, South Asians
Subjects:Diabetes Epidemiology
Divisions:Department of Epidemiology
Department of Clinical Trials
ID Code:1028
Deposited By:surendar radha
Deposited On:19 May 2017 15:27
Last Modified:19 May 2017 15:27

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