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Use of oral glucose tolerance testing and HbA1c at 6–14 gestational weeks to predict gestational diabetes mellitus in high-risk women

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To study the prediction of gestational diabetes mellitus (GDM) in high-risk pregnant women by testing fasting blood glucose, 1-h(1hPG) and 2-h plasma glucose (2hPG) after an oral glucose tolerance test, and glycated hemoglobin (HbA1c) in early pregnancy (6–14 weeks).

Methods

We recruited 1311 pregnant women at high risk for diabetes from the Obstetrics Clinic of Daxing District People’s Hospital between June 2017 and December 2019. The tests performed during the first trimester included fasting blood glucose (FPG), HbA1c, and 75-g oral glucose tolerance test (OGTT) with 1hPG and 2hPG. Seventy-three pregnant women diagnosed with pregestational diabetes mellitus (PGDM) early in pregnancy and 36 who were missed in the second trimester were excluded. A total of 1202 women were followed up until 24–28 weeks for GDM. The receiver operating characteristic (ROC) and area under the ROC curve (AUC) were calculated to determine the predictive values of FPG, 1hPG, 2hPG, and HbA1c for GDM in early pregnancy in high-risk pregnant women.

Results

The AUC for 1hPG for the prediction of GDM in high-risk pregnant women was greater than those for FPG, 2hPG, and HbA1c. All differences were significant.

The AUCs for the predictive values of FPG, 1hPG, 2hPG, and HbA1c in high-risk pregnant women were 0.63, 0.76, 0.71, and 0.67, respectively. The prevalence of PGDM among pregnant women at high risk of diabetes was 5.6%.

Conclusion

First-trimester levels of FPG, 1hPG, 2hPG, and HbA1c in high-risk women are significant predictors of GDM, with 1hPG having the most significant predictive value.

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Funding

This work was funded by The Capital Health Development Scientific Research Project (Grant no. 2018-3-7121); Promotion and application of early diabetes screening in high-risk pregnant women suitable for primary hospitals (Grant no. BHTPP202023).

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Authors and Affiliations

  1. Daxing District People’s Hospital, Beijing, 102600, People’s Republic of China

    Xiaoxiao Peng, Mingyi Liu, Jun Gang, Ying Wang & Xiuhua Ma

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  1. Xiaoxiao Peng
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  2. Mingyi Liu
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Contributions

Professor MX carried out the research design and article revision. PX was responsible for the specific implementation of the experiment, data collection, statistical analysis and article writing. LM, GJ, and WY participated in the writing process. The data is interpreted by all authors who participated in the writing and revision of the manuscript.

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Correspondence to Xiuhua Ma.

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Peng, X., Liu, M., Gang, J. et al. Use of oral glucose tolerance testing and HbA1c at 6–14 gestational weeks to predict gestational diabetes mellitus in high-risk women. Arch Gynecol Obstet 307, 1451–1457 (2023). https://doi.org/10.1007/s00404-022-06637-7

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