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CME Credit Offered
CME Credit Offered
Abstract Award
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Poster Session 1

(212) Association of Hemoglobin A1c and Glycosylated Albumin with Adverse Neonatal Outcomes in Gestational Diabetes

Thursday, January 30, 2025
10:30 AM – 12:30 PM  
Objective:
The predictive value of hemoglobin A1c (HbA1c) and glycosylated albumin (GA) levels for neonatal outcomes in women with gestational diabetes mellitus (GDM) remains controversial. This study aimed to investigate the association between these biomarkers and neonatal composite adverse outcomes and determine if this association depends on gestational age.

Study Design:
This retrospective study used the GDM clinical database of a tertiary perinatal care center in Japan. We included singleton pregnant women who had biomarker measurements during late pregnancy, after 30 weeks of gestation (WG). Biomarkers were measured monthly and collected within a three-week window for the periods of 31-33 WG, 33-36 WG, and 37-39 WG. Neonatal composite adverse outcomes included large-for-gestational-age infants, asphyxia, hypoglycemia, respiratory issues, and hyperbilirubinemia. A receiver operating characteristic curve was used to establish a cutoff value. We adjusted for body mass index, insulin therapy, gestational week at diagnosis and delivery, gestational weight gain, and hemoglobin values at 35 WG in assessing the association between the biomarkers and the composite adverse outcomes.

Results:
Among 460 neonates, 103 (22%) experienced composite adverse outcomes. HbA1c values at 34-36 WG were significantly associated with composite outcomes, with crude and adjusted odds ratios of 2.58 (95% confidence interval 1.36-4.86) and 2.36 (1.21-4.61) with a cutoff value of 5.9%, respectively. HbA1c values in the other two windows were not associated with adverse outcomes. GA values in any gestational week window showed no significant association with composite adverse outcomes.

Conclusion:
In women with GDM, HbA1c values at 34-36 WG were predictive of neonatal composite adverse outcomes. An HbA1c value of < 5.9% by 33 WG was associated with favorable outcomes, while GA measurements in any gestational week window were not useful.