Kim Mi Ju, Park Suyeon, Choi Sooran, Hong Subeen, Sung Ji-Hee, Seol Hyun-Joo, Lee Joon Ho, Kim Seung Cheol, Choi Sae-Kyoung, Kwon Ji Young, Lee Seung Mi, Lee Se Jin, Hwang Han-Sung, Lee Gi Su, Park Hyun Soo, Lee Soo-Jeong, Cho Geum Joon, Bae Jin-Gon, Seong Won Joon, Ko Hyun Sun
Department of Obstetrics and Gynecology, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea.
Department of Obstetrics and Gynecology, Inha University, Incheon 22212, Republic of Korea.
Life (Basel). 2024 Dec 1;14(12):1575. doi: 10.3390/life14121575.
This study compared glycosylated hemoglobin (HbA1c) levels in the first and second trimesters of pregnancy and assessed maternal and neonatal outcomes according to HbA1c variations among women with pregestational diabetes. This retrospective, multicenter Korean study involved mothers with diabetes who had given birth in 17 hospitals. A total of 292 women were divided into three groups based on HbA1c levels during the first and second trimesters: women with HbA1c levels maintained at <6.5% (well-controlled [WC] group); women with HbA1c ≥ 6.5% (poorly-controlled [PC] group); and women with HbA1c ≥ 6.5% in the first trimester but <6.5% in the second trimester (improved-control [IC] group). The PC group had the highest pregnancy-associated hypertension (PAH) incidence, while the incidence did not significantly differ between the WC and IC groups. The receiver operating characteristic (ROC) curve indicated that HbA1c in the second trimester could predict PAH with a cut-off value of 5.7%. The PC versus WC versus IC group showed statistically significantly higher neonatal birthweight and significantly higher rates of large for gestational age (LGA); however, those were not significantly different between the WC and IC groups. HbA1c levels in the second trimester could predict LGA, with a cut-off value of 5.4%. Therefore, the second trimester HbA1c levels were significantly associated with both maternal and neonatal outcomes.
本研究比较了妊娠早期和中期的糖化血红蛋白（HbA1c）水平，并根据孕前糖尿病女性的HbA1c变化评估母婴结局。这项回顾性、多中心的韩国研究纳入了在17家医院分娩的糖尿病母亲。根据妊娠早期和中期的HbA1c水平，将292名女性分为三组：HbA1c水平维持在<6.5%的女性（血糖控制良好[WC]组）；HbA1c≥6.5%的女性（血糖控制不佳[PC]组）；以及妊娠早期HbA1c≥6.5%但妊娠中期<6.5%的女性（血糖改善控制[IC]组）。PC组妊娠相关高血压（PAH）的发生率最高，而WC组和IC组之间的发生率没有显著差异。受试者工作特征（ROC）曲线表明，妊娠中期的HbA1c可以预测PAH，临界值为5.7%。PC组与WC组与IC组相比，新生儿出生体重在统计学上显著更高，大于胎龄（LGA）的发生率也显著更高；然而，WC组和IC组之间没有显著差异。妊娠中期的HbA1c水平可以预测LGA，临界值为5.4%。因此，妊娠中期的HbA1c水平与母婴结局均显著相关。
