Antenatal haemoglobin A1c and risk of large-for-gestational-age infants in a multi-ethnic cohort of women with gestational diabetes

Jodie Katon, Gayle Reiber, Michelle A. Williams, Norbert Yanez, Edith Miller

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Katon J, Reiber G, Williams MA, Yanez D, Miller E. Antenatal haemoglobin A1c and risk of large-for-gestational-age infants in a multi-ethnic cohort of women with gestational diabetes. Paediatric and Perinatal Epidemiology 2012; 26: 208-217. Gestational diabetes mellitus (GDM) is a risk factor for delivering a large-for-gestational-age (LGA) infant. Haemoglobin A1c (A1C) is an indicator of glycaemic control. The objective of this study was to test whether higher A1C quartile at the time of diagnosis of GDM is associated with increased risk of delivering a LGA or macrosomic infant. Women with singleton pregnancies treated for GDM at a large diabetes and pregnancy programme located in Charlotte, North Carolina, were eligible for inclusion in this retrospective cohort study. Clinical information, including A1C at diagnosis, treatment, prior medical and obstetric history, and birth data were abstracted from medical records. LGA was defined as birthweight >90th percentile for gestational age and sex and macrosomia as birthweight >4000 g. Logistic regression was used to analyse the association of A1C at GDM diagnosis with risk of delivering LGA or macrosomic infants. This study included 502 women. Prevalences of LGA and macrosomia were 4% and 6% respectively. After adjustment there was no detectable trend of increased risk for LGA (P for trend = 0.12) or macrosomia (P for trend = 0.20) across increasing quartiles of A1C at GDM diagnosis. A1C at GDM diagnosis may not be linearly associated with LGA or macrosomia, possibly because of the mediating effect of strict glycaemic control in this clinical setting.

Original languageEnglish (US)
Pages (from-to)208-217
Number of pages10
JournalPaediatric and Perinatal Epidemiology
Volume26
Issue number3
DOIs
StatePublished - May 2012
Externally publishedYes

Fingerprint

Gestational Diabetes
Gestational Age
Hemoglobins
Hemoglobin E
Pregnancy
Reproductive History
Obstetrics
Medical Records
Epidemiology
Cohort Studies
Retrospective Studies
Logistic Models
Pediatrics

Keywords

  • birthweight
  • gestational diabetes
  • glycaemic control
  • Hb A1c

ASJC Scopus subject areas

  • Epidemiology
  • Pediatrics, Perinatology, and Child Health

Cite this

Antenatal haemoglobin A1c and risk of large-for-gestational-age infants in a multi-ethnic cohort of women with gestational diabetes. / Katon, Jodie; Reiber, Gayle; Williams, Michelle A.; Yanez, Norbert; Miller, Edith.

In: Paediatric and Perinatal Epidemiology, Vol. 26, No. 3, 05.2012, p. 208-217.

Research output: Contribution to journalArticle

@article{03c8bdb80cd1486f99fb5553f13ac176,
title = "Antenatal haemoglobin A1c and risk of large-for-gestational-age infants in a multi-ethnic cohort of women with gestational diabetes",
abstract = "Katon J, Reiber G, Williams MA, Yanez D, Miller E. Antenatal haemoglobin A1c and risk of large-for-gestational-age infants in a multi-ethnic cohort of women with gestational diabetes. Paediatric and Perinatal Epidemiology 2012; 26: 208-217. Gestational diabetes mellitus (GDM) is a risk factor for delivering a large-for-gestational-age (LGA) infant. Haemoglobin A1c (A1C) is an indicator of glycaemic control. The objective of this study was to test whether higher A1C quartile at the time of diagnosis of GDM is associated with increased risk of delivering a LGA or macrosomic infant. Women with singleton pregnancies treated for GDM at a large diabetes and pregnancy programme located in Charlotte, North Carolina, were eligible for inclusion in this retrospective cohort study. Clinical information, including A1C at diagnosis, treatment, prior medical and obstetric history, and birth data were abstracted from medical records. LGA was defined as birthweight >90th percentile for gestational age and sex and macrosomia as birthweight >4000 g. Logistic regression was used to analyse the association of A1C at GDM diagnosis with risk of delivering LGA or macrosomic infants. This study included 502 women. Prevalences of LGA and macrosomia were 4{\%} and 6{\%} respectively. After adjustment there was no detectable trend of increased risk for LGA (P for trend = 0.12) or macrosomia (P for trend = 0.20) across increasing quartiles of A1C at GDM diagnosis. A1C at GDM diagnosis may not be linearly associated with LGA or macrosomia, possibly because of the mediating effect of strict glycaemic control in this clinical setting.",
keywords = "birthweight, gestational diabetes, glycaemic control, Hb A1c",
author = "Jodie Katon and Gayle Reiber and Williams, {Michelle A.} and Norbert Yanez and Edith Miller",
year = "2012",
month = "5",
doi = "10.1111/j.1365-3016.2012.01266.x",
language = "English (US)",
volume = "26",
pages = "208--217",
journal = "Paediatric and Perinatal Epidemiology",
issn = "0269-5022",
publisher = "Wiley-Blackwell",
number = "3",

}

TY - JOUR

T1 - Antenatal haemoglobin A1c and risk of large-for-gestational-age infants in a multi-ethnic cohort of women with gestational diabetes

AU - Katon, Jodie

AU - Reiber, Gayle

AU - Williams, Michelle A.

AU - Yanez, Norbert

AU - Miller, Edith

PY - 2012/5

Y1 - 2012/5

N2 - Katon J, Reiber G, Williams MA, Yanez D, Miller E. Antenatal haemoglobin A1c and risk of large-for-gestational-age infants in a multi-ethnic cohort of women with gestational diabetes. Paediatric and Perinatal Epidemiology 2012; 26: 208-217. Gestational diabetes mellitus (GDM) is a risk factor for delivering a large-for-gestational-age (LGA) infant. Haemoglobin A1c (A1C) is an indicator of glycaemic control. The objective of this study was to test whether higher A1C quartile at the time of diagnosis of GDM is associated with increased risk of delivering a LGA or macrosomic infant. Women with singleton pregnancies treated for GDM at a large diabetes and pregnancy programme located in Charlotte, North Carolina, were eligible for inclusion in this retrospective cohort study. Clinical information, including A1C at diagnosis, treatment, prior medical and obstetric history, and birth data were abstracted from medical records. LGA was defined as birthweight >90th percentile for gestational age and sex and macrosomia as birthweight >4000 g. Logistic regression was used to analyse the association of A1C at GDM diagnosis with risk of delivering LGA or macrosomic infants. This study included 502 women. Prevalences of LGA and macrosomia were 4% and 6% respectively. After adjustment there was no detectable trend of increased risk for LGA (P for trend = 0.12) or macrosomia (P for trend = 0.20) across increasing quartiles of A1C at GDM diagnosis. A1C at GDM diagnosis may not be linearly associated with LGA or macrosomia, possibly because of the mediating effect of strict glycaemic control in this clinical setting.

AB - Katon J, Reiber G, Williams MA, Yanez D, Miller E. Antenatal haemoglobin A1c and risk of large-for-gestational-age infants in a multi-ethnic cohort of women with gestational diabetes. Paediatric and Perinatal Epidemiology 2012; 26: 208-217. Gestational diabetes mellitus (GDM) is a risk factor for delivering a large-for-gestational-age (LGA) infant. Haemoglobin A1c (A1C) is an indicator of glycaemic control. The objective of this study was to test whether higher A1C quartile at the time of diagnosis of GDM is associated with increased risk of delivering a LGA or macrosomic infant. Women with singleton pregnancies treated for GDM at a large diabetes and pregnancy programme located in Charlotte, North Carolina, were eligible for inclusion in this retrospective cohort study. Clinical information, including A1C at diagnosis, treatment, prior medical and obstetric history, and birth data were abstracted from medical records. LGA was defined as birthweight >90th percentile for gestational age and sex and macrosomia as birthweight >4000 g. Logistic regression was used to analyse the association of A1C at GDM diagnosis with risk of delivering LGA or macrosomic infants. This study included 502 women. Prevalences of LGA and macrosomia were 4% and 6% respectively. After adjustment there was no detectable trend of increased risk for LGA (P for trend = 0.12) or macrosomia (P for trend = 0.20) across increasing quartiles of A1C at GDM diagnosis. A1C at GDM diagnosis may not be linearly associated with LGA or macrosomia, possibly because of the mediating effect of strict glycaemic control in this clinical setting.

KW - birthweight

KW - gestational diabetes

KW - glycaemic control

KW - Hb A1c

UR - http://www.scopus.com/inward/record.url?scp=84863401146&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84863401146&partnerID=8YFLogxK

U2 - 10.1111/j.1365-3016.2012.01266.x

DO - 10.1111/j.1365-3016.2012.01266.x

M3 - Article

VL - 26

SP - 208

EP - 217

JO - Paediatric and Perinatal Epidemiology

JF - Paediatric and Perinatal Epidemiology

SN - 0269-5022

IS - 3

ER -