Noriyuki Iwama1, Takashi Sugiyama2, Hirohito Metoki3, Masatoshi Saito4, Tetsuro Hoshiai5, Zen Watanabe6, Kosuke Tanaka7, Satomi Sasaki6, Kasumi Sakurai8, Mami Ishikuro9, Taku Obara10, Nozomi Tatsuta11, Hidekazu Nishigori12, Shin-Ichi Kuriyama13, Takahiro Arima14, Kunihiko Nakai15, Nobuo Yaegashi16. 1. Center for Perinatal Medicine, Tohoku University Hospital, 1-1, Seiryomachi, Sendai 980-8574, Miyagi, Japan; Tohoku Medical Megabank Organization, Tohoku University, 2-1, Seiryomachi, Sendai 980-8573, Miyagi, Japan. Electronic address: noriyuki.iwama@med.tohoku.ac.jp. 2. Department of Obstetrics and Gynecology, Ehime University Graduate School of Medicine, Toon 791-0295, Ehime, Japan. Electronic address: sugiyama@m.ehime-u.ac.jp. 3. Tohoku Medical Megabank Organization, Tohoku University, 2-1, Seiryomachi, Sendai 980-8573, Miyagi, Japan; Division of Public Health, Hygiene and Epidemiology, Tohoku Medical Pharmaceutical University, 1-15-1 Fukumuro, Sendai 983-8536, Miyagi, Japan. Electronic address: hmetoki@tohoku-mpu.ac.jp. 4. Center for Perinatal Medicine, Tohoku University Hospital, 1-1, Seiryomachi, Sendai 980-8574, Miyagi, Japan. 5. Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryomachi, Sendai 980-8574, Miyagi, Japan. Electronic address: t-hoshiai@umin.org. 6. Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryomachi, Sendai 980-8574, Miyagi, Japan. 7. Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryomachi, Sendai 980-8574, Miyagi, Japan. Electronic address: ko-tanaka@med.tohoku.ac.jp. 8. Environment and Genome Research Center, Tohoku University Graduate School of Medicine, 2-1, Seiryomachi, Sendai 980-8572, Miyagi, Japan. Electronic address: kasumi-s@med.tohoku.ac.jp. 9. Tohoku Medical Megabank Organization, Tohoku University, 2-1, Seiryomachi, Sendai 980-8573, Miyagi, Japan; Environment and Genome Research Center, Tohoku University Graduate School of Medicine, 2-1, Seiryomachi, Sendai 980-8572, Miyagi, Japan. Electronic address: m_ishikuro@med.tohoku.ac.jp. 10. Tohoku Medical Megabank Organization, Tohoku University, 2-1, Seiryomachi, Sendai 980-8573, Miyagi, Japan; Environment and Genome Research Center, Tohoku University Graduate School of Medicine, 2-1, Seiryomachi, Sendai 980-8572, Miyagi, Japan; Department of Pharmaceutical Sciences, Tohoku University Hospital, 1-1, Seiryomachi, Sendai 980-8574, Miyagi, Japan. Electronic address: obara-t@hosp.tohoku.ac.jp. 11. Environment and Genome Research Center, Tohoku University Graduate School of Medicine, 2-1, Seiryomachi, Sendai 980-8572, Miyagi, Japan. Electronic address: nozomi@med.tohoku.ac.jp. 12. Fukushima Medical Center for Children and Women, Fukushima Medical University, 1, Hikarigaoka, Fukushima 960-1295, Fukushima, Japan. Electronic address: nishigori@med.tohoku.ac.jp. 13. Tohoku Medical Megabank Organization, Tohoku University, 2-1, Seiryomachi, Sendai 980-8573, Miyagi, Japan; Environment and Genome Research Center, Tohoku University Graduate School of Medicine, 2-1, Seiryomachi, Sendai 980-8572, Miyagi, Japan; International Research Institute of Disaster Science, Tohoku University, 468-1, Aramaki, Sendai 980-8572, Miyagi, Japan. Electronic address: kuriyama@med.tohoku.ac.jp. 14. Environment and Genome Research Center, Tohoku University Graduate School of Medicine, 2-1, Seiryomachi, Sendai 980-8572, Miyagi, Japan. Electronic address: tarima@med.tohoku.ac.jp. 15. Environment and Genome Research Center, Tohoku University Graduate School of Medicine, 2-1, Seiryomachi, Sendai 980-8572, Miyagi, Japan. Electronic address: nakaik@med.tohoku.ac.jp. 16. Tohoku Medical Megabank Organization, Tohoku University, 2-1, Seiryomachi, Sendai 980-8573, Miyagi, Japan; Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryomachi, Sendai 980-8574, Miyagi, Japan; Environment and Genome Research Center, Tohoku University Graduate School of Medicine, 2-1, Seiryomachi, Sendai 980-8572, Miyagi, Japan. Electronic address: yaegashi@med.tohoku.ac.jp.
Abstract
AIMS: To investigate the associations between glycosylated hemoglobin (HbA1c) levels at less than 24 weeks of gestation and adverse pregnancy outcomes in Japan. METHODS: This was a prospective nationwide birth cohort study of 77,526 subjects with an HbA1c level of <6.5% (<48 mmol/mol) at less than 24 weeks of gestation. Associations of HbA1c level with adverse pregnancy outcomes were evaluated using multivariate analyses. RESULTS: The adjusted odds ratios per 1% (11 mmol/mol) increase in HbA1c level were 1.77 (95% confidence interval [CI]: 1.48-2.12) for hypertensive disorders of pregnancy; 1.78 (95% CI: 1.12-2.83) for placental abruption; 1.30 (95% CI: 1.12-1.50) for preterm birth; 2.11 (95% CI: 1.41-3.16) for very preterm birth; 1.49 (95% CI: 1.33-1.68) for low birth weight infants; 1.95 (95% CI: 1.42-2.70) for macrosomia; 1.23 (95% CI: 1.09-1.39) for small for gestational age; 1.15 (95% CI: 1.04-1.28) for large for gestational age; and 1.29 (95% CI: 1.20-1.39) for the composite adverse pregnancy outcome. CONCLUSIONS: The higher the HbA1c level, the higher the risk of adverse pregnancy outcomes in Japan. Further studies will be needed to determine prenatal management based on the HbA1c level in pregnant women with HbA1c <6.5% (<48 mmol/mol) at less than 24 weeks of gestation.
AIMS: To investigate the associations between glycosylated hemoglobin (HbA1c) levels at less than 24 weeks of gestation and adverse pregnancy outcomes in Japan. METHODS: This was a prospective nationwide birth cohort study of 77,526 subjects with an HbA1c level of <6.5% (<48 mmol/mol) at less than 24 weeks of gestation. Associations of HbA1c level with adverse pregnancy outcomes were evaluated using multivariate analyses. RESULTS: The adjusted odds ratios per 1% (11 mmol/mol) increase in HbA1c level were 1.77 (95% confidence interval [CI]: 1.48-2.12) for hypertensive disorders of pregnancy; 1.78 (95% CI: 1.12-2.83) for placental abruption; 1.30 (95% CI: 1.12-1.50) for preterm birth; 2.11 (95% CI: 1.41-3.16) for very preterm birth; 1.49 (95% CI: 1.33-1.68) for low birth weight infants; 1.95 (95% CI: 1.42-2.70) for macrosomia; 1.23 (95% CI: 1.09-1.39) for small for gestational age; 1.15 (95% CI: 1.04-1.28) for large for gestational age; and 1.29 (95% CI: 1.20-1.39) for the composite adverse pregnancy outcome. CONCLUSIONS: The higher the HbA1c level, the higher the risk of adverse pregnancy outcomes in Japan. Further studies will be needed to determine prenatal management based on the HbA1c level in pregnant women with HbA1c <6.5% (<48 mmol/mol) at less than 24 weeks of gestation.
Authors: Monika Bączkowska; Katarzyna Kosińska-Kaczyńska; Magdalena Zgliczyńska; Robert Brawura-Biskupski-Samaha; Beata Rebizant; Michał Ciebiera Journal: Int J Environ Res Public Health Date: 2022-04-23 Impact factor: 4.614
Authors: Yu Taniguchi; Shin Yamazaki; Shoji F Nakayama; Makiko Sekiyama; Takehiro Michikawa; Tomohiko Isobe; Miyuki Iwai-Shimada; Yayoi Kobayashi; Mai Takagi; Michihiro Kamijima Journal: Int J Environ Res Public Health Date: 2022-03-10 Impact factor: 3.390