Elevated glycated hemoglobin predicts macrosomia among Asian Indian pregnant women (WINGS-9)
Aim: The aim of this study was to determine the optimal glycated hemoglobin (HbA1c) cut point for diagnosis of gestational diabetes mellitus (GDM) and to evaluate the usefulness of HbA1c as a prognostic indicator for adverse pregnancy outcomes. Methods: HbA1c estimations were carried out in 1459 pre...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2017-01-01
|
| Series: | Indian Journal of Endocrinology and Metabolism |
| Subjects: | |
| Online Access: | http://www.ijem.in/article.asp?issn=2230-8210;year=2017;volume=21;issue=1;spage=184;epage=189;aulast=Bhavadharini |
| _version_ | 1819205212773023744 |
|---|---|
| author | Balaji Bhavadharini Manni Mohanraj Mahalakshmi Mohan Deepa Ranjani Harish Belma Malanda Arivudainambi Kayal Anne Belton Ponnusamy Saravanan Unnikrishnan Ranjit Ram Uma Ranjit Mohan Anjana Viswanathan Mohan |
| author_facet | Balaji Bhavadharini Manni Mohanraj Mahalakshmi Mohan Deepa Ranjani Harish Belma Malanda Arivudainambi Kayal Anne Belton Ponnusamy Saravanan Unnikrishnan Ranjit Ram Uma Ranjit Mohan Anjana Viswanathan Mohan |
| author_sort | Balaji Bhavadharini |
| collection | DOAJ |
| description | Aim: The aim of this study was to determine the optimal glycated hemoglobin (HbA1c) cut point for diagnosis of gestational diabetes mellitus (GDM) and to evaluate the usefulness of HbA1c as a prognostic indicator for adverse pregnancy outcomes. Methods: HbA1c estimations were carried out in 1459 pregnant women attending antenatal care centers in urban and rural Tamil Nadu in South India. An oral glucose tolerance test was carried out using 75 g anhydrous glucose, and GDM was diagnosed using the International Association of the Diabetes and Pregnancy Study Groups criteria. Results: GDM was diagnosed in 195 women. Receiver operating curves showed a HbA1c cut point of ≥ 5.0% (≥31 mmol/mol) have a sensitivity of 66.2% and specificity of 56.2% for identifying GDM (area under the curve 0.679, confidence interval [CI]: 0.655–0.703). Women with HbA1c ≥ 5.0% (≥31 mmol/mol) were significantly older and had higher body mass index, greater history of previous GDM, and a higher prevalence of macrosomia compared to women with HbA1c < 5.0% (<31 mmol/mol). The adjusted odds ratio for macrosomia in those with HbA1c ≥ 5.0% (≥31 mmol/mol) was 1.92 (CI: 1.24–2.97, P = 0.003). However, other pregnancy outcomes were not significantly different. Conclusion: In Asian Indian pregnant women, a HbA1c of 5.0% (31 mmol/mol) or greater is associated with increased risk of macrosomia. |
| first_indexed | 2024-12-23T04:48:07Z |
| format | Article |
| id | doaj.art-1e9980c5a2a14d78ab8c2066aefec395 |
| institution | Directory Open Access Journal |
| issn | 2230-8210 |
| language | English |
| last_indexed | 2024-12-23T04:48:07Z |
| publishDate | 2017-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Endocrinology and Metabolism |
| spelling | doaj.art-1e9980c5a2a14d78ab8c2066aefec3952022-12-21T17:59:33ZengWolters Kluwer Medknow PublicationsIndian Journal of Endocrinology and Metabolism2230-82102017-01-0121118418910.4103/2230-8210.196003Elevated glycated hemoglobin predicts macrosomia among Asian Indian pregnant women (WINGS-9)Balaji BhavadhariniManni Mohanraj MahalakshmiMohan DeepaRanjani HarishBelma MalandaArivudainambi KayalAnne BeltonPonnusamy SaravananUnnikrishnan RanjitRam UmaRanjit Mohan AnjanaViswanathan MohanAim: The aim of this study was to determine the optimal glycated hemoglobin (HbA1c) cut point for diagnosis of gestational diabetes mellitus (GDM) and to evaluate the usefulness of HbA1c as a prognostic indicator for adverse pregnancy outcomes. Methods: HbA1c estimations were carried out in 1459 pregnant women attending antenatal care centers in urban and rural Tamil Nadu in South India. An oral glucose tolerance test was carried out using 75 g anhydrous glucose, and GDM was diagnosed using the International Association of the Diabetes and Pregnancy Study Groups criteria. Results: GDM was diagnosed in 195 women. Receiver operating curves showed a HbA1c cut point of ≥ 5.0% (≥31 mmol/mol) have a sensitivity of 66.2% and specificity of 56.2% for identifying GDM (area under the curve 0.679, confidence interval [CI]: 0.655–0.703). Women with HbA1c ≥ 5.0% (≥31 mmol/mol) were significantly older and had higher body mass index, greater history of previous GDM, and a higher prevalence of macrosomia compared to women with HbA1c < 5.0% (<31 mmol/mol). The adjusted odds ratio for macrosomia in those with HbA1c ≥ 5.0% (≥31 mmol/mol) was 1.92 (CI: 1.24–2.97, P = 0.003). However, other pregnancy outcomes were not significantly different. Conclusion: In Asian Indian pregnant women, a HbA1c of 5.0% (31 mmol/mol) or greater is associated with increased risk of macrosomia.http://www.ijem.in/article.asp?issn=2230-8210;year=2017;volume=21;issue=1;spage=184;epage=189;aulast=BhavadhariniAdverse pregnancy outcomesAsian Indiansglycated hemoglobinmacrosomiaSouth Asians |
| spellingShingle | Balaji Bhavadharini Manni Mohanraj Mahalakshmi Mohan Deepa Ranjani Harish Belma Malanda Arivudainambi Kayal Anne Belton Ponnusamy Saravanan Unnikrishnan Ranjit Ram Uma Ranjit Mohan Anjana Viswanathan Mohan Elevated glycated hemoglobin predicts macrosomia among Asian Indian pregnant women (WINGS-9) Indian Journal of Endocrinology and Metabolism Adverse pregnancy outcomes Asian Indians glycated hemoglobin macrosomia South Asians |
| title | Elevated glycated hemoglobin predicts macrosomia among Asian Indian pregnant women (WINGS-9) |
| title_full | Elevated glycated hemoglobin predicts macrosomia among Asian Indian pregnant women (WINGS-9) |
| title_fullStr | Elevated glycated hemoglobin predicts macrosomia among Asian Indian pregnant women (WINGS-9) |
| title_full_unstemmed | Elevated glycated hemoglobin predicts macrosomia among Asian Indian pregnant women (WINGS-9) |
| title_short | Elevated glycated hemoglobin predicts macrosomia among Asian Indian pregnant women (WINGS-9) |
| title_sort | elevated glycated hemoglobin predicts macrosomia among asian indian pregnant women wings 9 |
| topic | Adverse pregnancy outcomes Asian Indians glycated hemoglobin macrosomia South Asians |
| url | http://www.ijem.in/article.asp?issn=2230-8210;year=2017;volume=21;issue=1;spage=184;epage=189;aulast=Bhavadharini |
| work_keys_str_mv | AT balajibhavadharini elevatedglycatedhemoglobinpredictsmacrosomiaamongasianindianpregnantwomenwings9 AT mannimohanrajmahalakshmi elevatedglycatedhemoglobinpredictsmacrosomiaamongasianindianpregnantwomenwings9 AT mohandeepa elevatedglycatedhemoglobinpredictsmacrosomiaamongasianindianpregnantwomenwings9 AT ranjaniharish elevatedglycatedhemoglobinpredictsmacrosomiaamongasianindianpregnantwomenwings9 AT belmamalanda elevatedglycatedhemoglobinpredictsmacrosomiaamongasianindianpregnantwomenwings9 AT arivudainambikayal elevatedglycatedhemoglobinpredictsmacrosomiaamongasianindianpregnantwomenwings9 AT annebelton elevatedglycatedhemoglobinpredictsmacrosomiaamongasianindianpregnantwomenwings9 AT ponnusamysaravanan elevatedglycatedhemoglobinpredictsmacrosomiaamongasianindianpregnantwomenwings9 AT unnikrishnanranjit elevatedglycatedhemoglobinpredictsmacrosomiaamongasianindianpregnantwomenwings9 AT ramuma elevatedglycatedhemoglobinpredictsmacrosomiaamongasianindianpregnantwomenwings9 AT ranjitmohananjana elevatedglycatedhemoglobinpredictsmacrosomiaamongasianindianpregnantwomenwings9 AT viswanathanmohan elevatedglycatedhemoglobinpredictsmacrosomiaamongasianindianpregnantwomenwings9 |