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Title: Congenital malformation and hemoglobin A1c in the first trimester among Japanese women with pregestational diabetes

Journal Article · · Journal of Obstetrics and Gynaecology Research
DOI: https://doi.org/10.1111/jog.15015 · OSTI ID:1996899
ORCiD logo [1];  [1];  [2];  [1];  [2]
  1. Department of Maternal Fetal Medicine Osaka Women's and Children's Hospital Osaka Japan
  2. Department of Obstetric Medicine Osaka Women's and Children's Hospital Osaka Japan
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Abstract Aim To investigate the incidence of major congenital malformations in Japanese women with pregestational diabetes, and to determine the cutoff value of hemoglobin A1c (HbA1c) in the first trimester associated with congenital malformations. Methods This retrospective cohort study included singleton pregnancies in Japanese women with pregestational diabetes, including type 1 and type 2 diabetes, and specific types of diabetes due to other causes. The primary outcome was the incidence of major congenital malformations. The secondary outcome was the incidence of all congenital malformations. The cutoff value of HbA1c for congenital malformations was calculated using receiver operating characteristic curve analysis. The adjusted odds ratios (aOR) of major congenital malformations were calculated using multiple logistic regression analyses. Results This study enrolled 292 patients, including 132 (45.2%) with type 1 diabetes, 156 (53.4%) with type 2 diabetes, and 4 (1.4%) with other specific types. The incidence rates of major congenital malformations and all congenital malformations were 7.2% (21/292) and 12.7% (37/292), respectively. The cutoff value of HbA1c in the first trimester for major malformations and for all congenital malformations was 6.5%. HbA1c ≥ 6.5% was significantly associated with major malformations (aOR 3.5; 95% confidence interval: 1.2–12.6; p  = 0.018). Conclusion The incidence of major congenital malformations significantly increased in pregnant Japanese women with HbA1c values of 6.5% or higher. The recommended HbA1c value during the first trimester used in other countries can be applied to pregnant Japanese women.

Sponsoring Organization:
USDOE
OSTI ID:
1996899
Journal Information:
Journal of Obstetrics and Gynaecology Research, Journal Name: Journal of Obstetrics and Gynaecology Research Journal Issue: 12 Vol. 47; ISSN 1341-8076
Publisher:
Wiley-BlackwellCopyright Statement
Country of Publication:
Country unknown/Code not available
Language:
English

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