Gestational diabetes & diabetes in pregnancy
Early pregnancy HbA1c as the first screening test for gestational diabetes: results from three prospective cohorts
Authors' conclusion
Early pregnancy HbA1c offers a simple screening test for gestational diabetes, allowing those at highest risk to receive early intervention and greatly reduce the need for OGTTs. This can also be carried out using point-of-care HbA1c in LMICs.
Study context
- Population
- Pregnant women aged 18–50 years at <16 weeks of gestation (<20 weeks in Kenya), confirmed by dating ultrasound; GDM by current WHO criteria
- Participants
- 3,070 / 4,104 / 4,320
- Exposure
- Early pregnancy HbA1c for predicting GDM at 24-28 weeks
- Indian = 3,070
- Kenyan = 4,104
- UKn = 4,320
- Outcome
- Efficacy of early pregnancy HbA1c (venous and capillary point-of-care), alone or in composite risk score with age, BMI and family history of DM, in predicting GDM
- Follow-up
- 24-28 weeks of gestation
Methodological detailsmulticentre, three cohorts, Enrolment Feb 15, 2016 to Dec 13, 2019
- Multicentre
- Three cohorts
- Enrolment Feb 15, 2016 to Dec 13, 2019
Main finding
As reported in the abstract
Association of early pregnancy HbA1c with GDM incidence
| Group | Adjusted RR |
|---|---|
| India | 1.60 (95% CI 1.19-2.16) |
| Kenya | 3.49 (2.8-4.34) |
| UK | 4.72 (3.82-5.82) |
Adjusted RR
India1.60 (95% CI 1.19-2.16)
Kenya3.49 (2.8-4.34)
UK4.72 (3.82-5.82)
Observational data: associations, not effects.
Secondary outcomes
GDM prevalence by OGTT · 24-28 weeks
HbA1c-alone model thresholds
Rule in
Rule out
Reduction in oral glucose tolerance test (OGTT) requirement with two-threshold rule-in/rule-out composite risk score strategy
- Reduction in OGTT requirement
- 50-64%
- Population-specific
Original publication
Early pregnancy HbA1c as the first screening test for gestational diabetes: results from three prospective cohorts. Lancet Diabetes Endocrinol. Published 24 June 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →