Key result
An increasing difference between mid- and third trimester HbA1c values correlated positively with higher birthweight centiles (Group A: r=0.51, p<0.01; Group B: r=0.28, p=0.01).
Why the study?
Pregestational diabetes carries risks of adverse outcomes such as macrosomia, and it was unclear whether sequential HbA1c levels during pregnancy predict macrosomia.
Do sequential HbA1c levels predict offspring birthweights in women with pregestational diabetes?
Cohort (n=112)
No
Do sequential HbA1c levels predict offspring birthweights in women with pregestational diabetes?
Effect estimate: r = 0.51 (Group A), r = 0.28 (Group B)
p-value: p=<0.01 (Group A), 0.01 (Group B)
An increasing difference between mid- and third trimester HbA1c values correlates with higher birthweight centiles in women with pregestational diabetes.
Worsening mid-to-third trimester HbA1c trends were associated with higher birthweight centiles; leaves open whether sequential monitoring improves macrosomia prediction.
Background: Pregestational diabetes poses risks of adverse pregnancy outcomes including macrosomia. Haemoglobin A1c (HbA1c) levels provide information on glycaemia over time.Objectives: The primary aim was to assess whether sequential HbA1c levels predict macrosomia. Secondary aims included gestational age at delivery.Design: All women in Tygerberg Academic Hospital with pregestational diabetes, who delivered from January 1, 2022 to June 30, 2024 were included. The Ethics Committee of Stellenbosch University granted approval.Results: Of the 112 patients, 28% had Type 1 diabetes or LADA, collectively designated Group A. 72% of all patients had Type 2 diabetes or MODY, collectively designated Group B. The proportion of macrosomic babies was 26% in Group A, and 24% in Group B. Amongst macrosomic babies, 50% were born preterm in Group A, and 10% in Group B. In Group B, a low positive correlation was observed between the third trimester HbA1c and the birthweight centile (p = 0.03, r = 0.24). Furthermore, the difference between the mid- and third trimester HbA1c values showed that the greater the upward difference, the higher the birthweight centile (Group A: p < 0.01, r = 0.51; Group B p = 0.01, r = 0.28).Conclusion: An increasing difference between mid- and third trimester HbA1c values correlated positively with higher birthweight centiles.
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Hassim et al. (2025) conducted a cohort in Pregestational diabetes (n=112). Sequential HbA1c levels was evaluated on Macrosomia and birthweight centile (r = 0.51 (Group A), r = 0.28 (Group B), p=<0.01 (Group A), 0.01 (Group B)). An increasing difference between mid- and third trimester HbA1c values correlated positively with higher birthweight centiles (Group A: r=0.51, p<0.01; Group B: r=0.28, p=0.01).
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