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ORIGINAL ARTICLE
Year : 2018  |  Volume : 7  |  Issue : 3  |  Page : 136-140

Elevated glycated hemoglobin during pregnancy in diabetic women as a predictor of large-for-gestational age infants in an Asian cohort


1 Department of General Pediatrics and Neonatology, Kandang Kerbau Women's and Children's Hospital; NUS Yong Loo Lin School of Medicine, Nanyang Technological University, Singapore
2 Department of General Pediatrics and Neonatology, Kandang Kerbau Women's and Children's Hospital; NUS Yong Loo Lin School of Medicine, Nanyang Technological University; Department of Neonatology, Kandang Kerbau Women's and Children's Hospital; Duke Nus Medical School; Lee Kong Chian Imperial School of Medicine, Nanyang Technological University, Singapore

Correspondence Address:
Dr. R R Pravin
Kandang Kerbau Women's and Children's Hospital, Singapore. NUS Yong Loo Lin School of Medicine
Singapore
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcn.JCN_13_18

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Introduction: Diabetes mellitus in pregnancy is often associated with large-for-gestational-age (LGA) infants. However, there is substantial variation in the reported relationship between LGA infants and glycated hemoglobin (HbA1c) values in pregnancies complicated by diabetes mellitus. Our study aims to investigate whether elevated HbA1c values (≥6.5%) during pregnancy are associated with a higher risk of an LGA infant (birth weight ≥90th percentile for gestational age). Methods: A retrospective study was done on a study population of 202 women with diabetes in pregnancy, whose babies were born healthy and at term (37 + 0—41 + 6 weeks) at KK Women's and Children's Hospital, Singapore, between January 1, 2012, and December 31, 2013. Relevant maternal and neonatal data including maternal HbA1c values were extracted from the electronic medical records system. Results: Mothers who had LGA infants had significantly higher HbA1c values as compared against those without (6.8 ± 1.2 vs. 5.8 ± 0.9, P < 0.001). After adjusting for demographics and gestational age, the odds of an LGA infant for women with HbA1c values of ≥6.5% was 8.5 times greater than those with HbA1c <6.5% (odds ratio [OR] 8.5, 95% confidence interval [CI]: 3.6—20.2, P < 0.0001). For each percent increase in HbA1c, the odds of an LGA infant doubled (OR: 2.1, 95% CI: 1.4—3.0, P < 0.0001). Conclusion: Women with HbA1c ≥6.5% during pregnancy have more than eight times the risk of having an LGA infant as compared to women with HbA1c levels <6.5% during pregnancy. Moreover, every 1% increase in HbA1c levels during pregnancy doubled the odds of having an LGA infant.


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