Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Institute of Maternal and Child Health, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.
J Clin Endocrinol Metab. 2020 Jun 1;105(6). doi: 10.1210/clinem/dgaa127.
Higher blood glucose level during gestational periods has been consistently associated with increased risk of adverse birth outcomes. Evidence regarding the association between higher glycated hemoglobin A1c (HbA1c) within the normal range and adverse birth outcomes is limited.
We aimed to examine the association between HbA1c within the normal range and the risk of adverse birth outcomes.
The data were abstracted from the Information System of Guangdong Women and Children Hospital, China, from September 2014 to March 2018.
A total of 5658 pregnant women with normal gestational HbA1c were included in this analysis.
The adverse birth outcomes include preterm birth, macrosomia, and large for gestational age (LGA).
Among 5658 subjects, the rates of preterm birth, macrosomia, and LGA were 4.6% (261/5658), 3.5% (200/5658), and 5.7% (325/5658), respectively. The results of multivariate logistic regression model showed that each 1% increase in maternal HbA1c was positively associated with increased risks of preterm birth (OR 1.58; 95% CI, 1.08-2.31), macrosomia (OR 1.70; 95% CI, 1.10-2.64), and LGA (OR 1.38; 95% CI, 0.98-1.96). The association between gestational HbA1c and preterm birth was more evident among women with prepregnancy body mass index (BMI) ≤ 24 kg/m2.
Gestational higher HbA1c level within the normal range is an independent risk factor for preterm birth, macrosomia, and LGA. Intervention for reducing HbAc1 may help to prevent adverse birth outcomes.
妊娠期较高的血糖水平与不良出生结局的风险增加密切相关。糖化血红蛋白 A1c（HbA1c）在正常范围内升高与不良出生结局之间的关联证据有限。
我们旨在研究 HbA1c 在正常范围内与不良出生结局风险之间的关联。
数据从中国广东妇女儿童医院的信息系统中提取，时间为 2014 年 9 月至 2018 年 3 月。
共有 5658 名 HbA1c 正常妊娠的孕妇纳入本分析。
不良出生结局包括早产、巨大儿和大于胎龄儿（LGA）。
在 5658 名受试者中，早产、巨大儿和 LGA 的发生率分别为 4.6%（261/5658）、3.5%（200/5658）和 5.7%（325/5658）。多变量 logistic 回归模型的结果显示，母亲 HbA1c 每增加 1%，早产的风险就会增加（OR 1.58；95%CI，1.08-2.31）、巨大儿（OR 1.70；95%CI，1.10-2.64）和 LGA（OR 1.38；95%CI，0.98-1.96）。在孕前 BMI≤24kg/m2 的女性中，妊娠期 HbA1c 与早产之间的关联更为明显。
正常范围内的妊娠 HbA1c 水平升高是早产、巨大儿和 LGA 的独立危险因素。降低 HbAc1 的干预措施可能有助于预防不良出生结局。
