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Cited by 43Gestational Diabetes Research and ManagementDiabetes Management and ResearchDiabetes, Cardiovascular Risks, and Lipoproteins

The role of first-trimester HbA1c in the early detection of gestational diabetes

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Valadan, Mehrnaz, Bahramnezhad, Zeinab, Golshahi, Fatemeh, Feizabad, Elham·2022·BMC Pregnancy and Childbirth
DOI 10.1186/s12884-021-04330-2PMC PMC8793236
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Abstract

Background: We aimed to assess the utility of HbA1c in the early detection of gestational diabetes (GDM) in the first trimester. Methods: This prospective study was performed on 700 pregnant women in the perinatology clinic at a tertiary university hospital from March 2018 to March 2020. For all pregnant women, HbA1c and fasting blood glucose (FBG) levels were examined during the first trimester. Then, a GDM screening test was done within 24–28 weeks of pregnancy using a 100 g oral glucose tolerance test (OGTT) as the gold standard test. The GDM diagnosis was made according to the American Diabetes Association (ADA) criteria. Sensitivity, specificity, positive (PPV), and negative predictive value (NPV) of HbA1c and FBG were calculated using the receiver operating characteristic (ROC) curve. Results: Of 700 participants, one hundred and fifteen (16.4%) women had GDM. The GDM patients were significantly older and had a higher pre-gestational body mass index and pregnancy weight gain compared to the non-GDM participants. The sensitivity and specificity for ruling out GDM at an HbA1c cut-off value of 4.85% was 92.2 and 32.8%, respectively, with a 95.5% NPV and a 21.2% PPV. Furthermore, sensitivity and specificity for diagnosing GDM at an HbA1c cut-off value of 5.45% was 54.8 and 96.8%, respectively, with a 91.5% NPV and a 76.8% PPV. Using HbA1c could decline OGTT in 40.4% of the pregnant women (28.7% with HbA1c < 4.85 and 11.7% with HbA1c ≥ 5.45%). Conclusion: It seems that the first-trimester HbA1c cannot replace OGTT for the diagnosis of GDM because of its insufficient sensitivity and specificity. However, women with higher first-trimester HbA1c had a high risk for GDM incidence.

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  • First-trimester glycated hemoglobin assessment is an additional prognostic marker and should not be analyzed separately.

    “The first-trimester glycated hemoglobin (HbA1c) assessment is pointed out to be an additional prognostic marker and should not be analyzed separately.”

    From Evolution of Gestational Diabetes Mellitus across Continents in 21st Century (2022) · cites this paper as [10]

  • First-trimester glycated hemoglobin has insufficient sensitivity and specificity and may not detect the whole population of patients.

    “Its insufficient sensitivity and specificity may not detect the whole population of patients [10,11].”

    From Evolution of Gestational Diabetes Mellitus across Continents in 21st Century (2022) · cites this paper as [10]

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Cited by

Sorted by citations

Authors
Valadan, M., Bahramnezhad, Z., Golshahi, F., & Feizabad, E.
Affiliations
Yas Hospital (IR)
Corresponding author
Feizabad, Elham
ORCID
Venue
BMC Pregnancy and Childbirth
Publisher
Springer Science and Business Media LLC
Published
2022-01-27
Volume
22
Issue
1
Pages
71-71
ISSN
1471-2393 (ISSN-L)
DOI
10.1186/s12884-021-04330-2
PMC
PMC8793236
OpenAlex
W4210297050
Cited by
43
References
2
Citations by year
2026: 9 · 2025: 12 · 2024: 11 · 2023: 8 · 2022: 3
FWCI
8.53
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Pregnancy and Childbirth (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
gestational diabetes mellitus, HbA1c, first trimester, early detection, fasting blood glucose, oral glucose tolerance test, diagnostic accuracy, screening, predictive value
MeSH terms
Adult, Blood Glucose, Female, Glycated Hemoglobin, Humans, Predictive Value of Tests, Pregnancy, Pregnancy Trimester, First, Prospective Studies, ROC Curve, Sensitivity and Specificity, Diabetes, Gestational, Early Diagnosis

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