Journal of Diabetes Investigation (Apr 2022)

Association of glycated hemoglobin at an early stage of pregnancy with the risk of gestational diabetes mellitus among non‐diabetic women in Japan: The Japan Environment and Children’s Study

  • Tetsuo Sekine,
  • Kyoichiro Tsuchiya,
  • Hiroyuki Uchinuma,
  • Sayaka Horiuchi,
  • Megumi Kushima,
  • Sanae Otawa,
  • Hiroshi Yokomichi,
  • Kunio Miyake,
  • Yuka Akiyama,
  • Tadao Ooka,
  • Reiji Kojima,
  • Ryoji Shinohara,
  • Shuji Hirata,
  • Zentaro Yamagata,
  • The Japan Environment and Children’s Study Group

DOI
https://doi.org/10.1111/jdi.13701
Journal volume & issue
Vol. 13, no. 4
pp. 687 – 695

Abstract

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Abstract Aims/Introduction Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy and is associated with adverse pregnancy outcomes. This study aimed to explore the associations between glycated hemoglobin (HbA1c) levels at the early stage of pregnancy and the GDM risk among non‐diabetic women in a nationwide study in Japan. In addition, the relationship between GDM and adverse pregnancy outcomes was also analyzed. Materials and Methods This cohort study (n = 89,799) used data from the Japan Environment and Children’s Study. We stratified the participants into four groups according to HbA1c levels at an early stage of pregnancy. We investigated the association of HbA1c at an early stage of pregnancy with the risk of GDM, and of GDM with the risk of some representative adverse pregnancy outcomes, using the multiple logistic regression model with adjustment for potential confounders. Results The adjusted odds ratio for GDM per 0.1 percentage point increase in HbA1c (%) was 1.20. The adjusted odds ratio for developing GDM was significantly increased in women from the HbA1c 5.0–5.4% category. GDM significantly increased the adjusted odds ratio for adverse pregnancy outcomes, such as hypertensive disorders of pregnancy, polyhydramnios and premature birth. Conclusions High‐normal HbA1c levels at the early stage of pregnancy are significantly associated with GDM risk in women in Japan. GDM was significantly associated with adverse pregnancy outcomes.

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