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HbA1c and Gestational Weight Gain Are Factors that Influence Neonatal Outcome in Mothers with Gestational Diabetes.
J Womens Health (Larchmt) 2016; 25(6):579-85JW

Abstract

BACKGROUND

Maternal glucose and weight gain are related to neonatal outcome in women with gestational diabetes mellitus (GDM). The aim of this study was to explore the influence of average third-trimester HbA1c and excess gestational weight gain on GDM neonatal complications.

MATERIALS AND METHODS

This observational study included 2037 Spanish singleton pregnant women with GDM followed in our Diabetes and Pregnancy Unit. The maternal HbA1c level was measured monthly from GDM diagnosis to delivery. Women were compared by average HbA1c level and weight gain categorized into ≤ or > the current Institute of Medicine (IOM) recommendations for body mass index. The differential effects of these factors on large-for-gestational-age birth weight and a composite of neonatal complications were assessed.

RESULTS

Women with an average third-trimester HbA1c ≥5.0% (n = 1319) gave birth to 7.3% versus 3.8% (p = 0.005) of large-for-gestational-age neonates and 22.0% versus 16.0% (p = 0.006) of neonates with complications. Women with excess gestational weight gain (n = 299) delivered 12.5% versus 5.2% (p < 0.001) of large-for-gestational-age neonates and 24.7% versus 19.0% (p = 0.022) of neonates with complications. In an adjusted multiple logistic regression analysis among mothers exposed to the respective risk factors, ∼47% and 52% of large-for-gestational-age neonates and 32% and 37% of neonatal complications were potentially preventable by attaining an average third-trimester HbA1c level <5.0% and optimizing gestational weight gain.

CONCLUSIONS

Average third-trimester HbA1c level ≥5% and gestational weight gain above the IOM recommendation are relevant risk factors for neonatal complications in mothers with gestational diabetes.

Authors+Show Affiliations

1 Diabetes and Pregnancy Unit, Division of Diabetes, Hospital Universitario La Paz , Madrid, Spain .1 Diabetes and Pregnancy Unit, Division of Diabetes, Hospital Universitario La Paz , Madrid, Spain .1 Diabetes and Pregnancy Unit, Division of Diabetes, Hospital Universitario La Paz , Madrid, Spain .2 Diabetes and Pregnancy Unit, Department of Obstetrics, Hospital Universitario La Paz , Madrid, Spain .3 Diabetes and Pregnancy Unit, Department of Biochemistry, Hospital Universitario La Paz , Madrid, Spain .4 Division of Hematology/Oncology, Department of Medicine, University of Miami School of Medicine , Miami, Florida.2 Diabetes and Pregnancy Unit, Department of Obstetrics, Hospital Universitario La Paz , Madrid, Spain .1 Diabetes and Pregnancy Unit, Division of Diabetes, Hospital Universitario La Paz , Madrid, Spain .

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

26918922

Citation

Barquiel, Beatriz, et al. "HbA1c and Gestational Weight Gain Are Factors That Influence Neonatal Outcome in Mothers With Gestational Diabetes." Journal of Women's Health (2002), vol. 25, no. 6, 2016, pp. 579-85.
Barquiel B, Herranz L, Hillman N, et al. HbA1c and Gestational Weight Gain Are Factors that Influence Neonatal Outcome in Mothers with Gestational Diabetes. J Womens Health (Larchmt). 2016;25(6):579-85.
Barquiel, B., Herranz, L., Hillman, N., Burgos, M. Á., Grande, C., Tukia, K. M., ... Pallardo, L. F. (2016). HbA1c and Gestational Weight Gain Are Factors that Influence Neonatal Outcome in Mothers with Gestational Diabetes. Journal of Women's Health (2002), 25(6), pp. 579-85. doi:10.1089/jwh.2015.5432.
Barquiel B, et al. HbA1c and Gestational Weight Gain Are Factors That Influence Neonatal Outcome in Mothers With Gestational Diabetes. J Womens Health (Larchmt). 2016;25(6):579-85. PubMed PMID: 26918922.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - HbA1c and Gestational Weight Gain Are Factors that Influence Neonatal Outcome in Mothers with Gestational Diabetes. AU - Barquiel,Beatriz, AU - Herranz,Lucrecia, AU - Hillman,Natalia, AU - Burgos,Ma Ángeles, AU - Grande,Cristina, AU - Tukia,Keleni M, AU - Bartha,José Luis, AU - Pallardo,Luis Felipe, Y1 - 2016/02/26/ PY - 2016/2/27/entrez PY - 2016/2/27/pubmed PY - 2017/5/30/medline SP - 579 EP - 85 JF - Journal of women's health (2002) JO - J Womens Health (Larchmt) VL - 25 IS - 6 N2 - BACKGROUND: Maternal glucose and weight gain are related to neonatal outcome in women with gestational diabetes mellitus (GDM). The aim of this study was to explore the influence of average third-trimester HbA1c and excess gestational weight gain on GDM neonatal complications. MATERIALS AND METHODS: This observational study included 2037 Spanish singleton pregnant women with GDM followed in our Diabetes and Pregnancy Unit. The maternal HbA1c level was measured monthly from GDM diagnosis to delivery. Women were compared by average HbA1c level and weight gain categorized into ≤ or > the current Institute of Medicine (IOM) recommendations for body mass index. The differential effects of these factors on large-for-gestational-age birth weight and a composite of neonatal complications were assessed. RESULTS: Women with an average third-trimester HbA1c ≥5.0% (n = 1319) gave birth to 7.3% versus 3.8% (p = 0.005) of large-for-gestational-age neonates and 22.0% versus 16.0% (p = 0.006) of neonates with complications. Women with excess gestational weight gain (n = 299) delivered 12.5% versus 5.2% (p < 0.001) of large-for-gestational-age neonates and 24.7% versus 19.0% (p = 0.022) of neonates with complications. In an adjusted multiple logistic regression analysis among mothers exposed to the respective risk factors, ∼47% and 52% of large-for-gestational-age neonates and 32% and 37% of neonatal complications were potentially preventable by attaining an average third-trimester HbA1c level <5.0% and optimizing gestational weight gain. CONCLUSIONS: Average third-trimester HbA1c level ≥5% and gestational weight gain above the IOM recommendation are relevant risk factors for neonatal complications in mothers with gestational diabetes. SN - 1931-843X UR - https://www.unboundmedicine.com/medline/citation/26918922/HbA1c_and_Gestational_Weight_Gain_Are_Factors_that_Influence_Neonatal_Outcome_in_Mothers_with_Gestational_Diabetes_ L2 - https://www.liebertpub.com/doi/full/10.1089/jwh.2015.5432?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -