News

Glucose levels linked to maternal mortality even in non-diabetic women

An elevated pre-pregnancy hemoglobin A1c -- which measures average blood glucose concentration -- is associated with a higher risk of adverse pregnancy outcomes even in women without known diabetes, according to a new study published this week in PLOS Medicine by Joel Ray of ICES and the University of Toronto, Canada, and colleagues.

advertisement

Diabetes mellitus and obesity are both associated with adverse pregnancy outcomes but the relationship between pre-pregnancy A1c and severe maternal morbidity or maternal mortality is unknown. In the new study, researchers used data from the Canadian province of Ontario spanning 2007 through 2015. The study included data on 31,225 women aged 16 through 50 years with a hospital live birth or stillbirth and who had an A1c measured within 90 days before conception. 28,075 of the women (90%) did not have a known diagnosis of diabetes mellitus.

Overall, the risk of severe maternal morbidity (SMM) or death from 23 weeks gestation to 6 weeks postpartum was 2.2%. For each 0.5% absolute increase in A1c, the relative risk of SMM or death was 1.16 (95% CI 1.14-1.19, p<0.001) after adjusting for maternal age, multifetal pregnancy, world region of origin, and tobacco/drug dependence. Compared to those with a healthy preconception A1c (below 5.8%), the adjusted relative risk of SMM or death was 1.31 (95% CI 1.06-1.62, p=0.01) in those with a preconception A1c of 5.8-6.4% and 2.84 (95% CI 2.31-3.49, p<0.001) in those with a preconception A1c greater than 6.4%. Among women without a diagnosis of diabetes who had an A1c over 6.4%, the adjusted relative risk was 3.25 (95% CI 1.76-6.00, p<0.001).

The authors note that most women do not undergo A1c testing, which may have led to selection bias among the cohort. Additionally, pre-pregnancy body mass index was unknown for 77% of the participants. Therefore, the potential interaction between BMI, A1c and risk of SMM should be investigated further. Still, these findings have implications for pre-pregnancy health screening.

"Given its convenient and widespread use, A1c testing may identify those women with preexisting diabetes mellitus at risk of severe maternal mortality, in a manner similar to its current use in recognizing those at higher risk of fetal anomalies, preterm birth and pre-eclampsia," the authors say. "As there is no current recommendation about A1c testing in nondiabetic pregnant women, especially those with obesity and/or chronic hypertension, our findings may enhance research about the benefits of A1c screening in these women."

Materials provided by PLOS . Note: Content may be edited for style and length.

PLOS. "Glucose levels linked to maternal mortality even in non-diabetic women." ScienceDaily. ScienceDaily, 22 May 2020. .

PLOS. "Glucose levels linked to maternal mortality even in non-diabetic women." ScienceDaily. www.sciencedaily.com/releases/2020/05/200522105751.htm (accessed May 22, 2020).

advertisement

1

Sep. 11, 2018 — Mothers with elevated blood glucose during pregnancy -- even if not high enough to meet the traditional definition of gestational diabetes -- were significantly more likely to have developed type 2 ...

Apr. 2, 2018 — A new study finds that women who are considering pregnancy would benefit from greater fitness. Using 25 years of data on pre-pregnant women, the researchers report that higher levels of pre-pregnancy ...

Sep. 29, 2015 — Pregnant women with systemic lupus erythematosus, are at higher risk for adverse pregnancy outcomes, including preeclampsia, placental insufficiency, fetal death, miscarriages, and other ...

July 22, 2015 — Levels of biomarkers in the blood of pregnant women can be used to predict which women are at risk of pre-eclampsia, finds a new study. Pre-eclampsia is a combination of raised blood pressure ...
Read more on sciencedaily.com
News Topics :
RELATED STORIES :
Science
The risk of potentially life threatening morbidity around childbirth, such as renal failure, obstetric shock, and amniotic fluid embolism, increases in older mothers, according to a study published by Sarka Lisonkova...
Science
Hypertensive pregnancy disorders, especially preeclampsia, a form of high blood pressure during pregnancy, may lead to adverse mental health conditions in children, according to new research published today in Hypertension,...
Science
In a research article published in PLOS Medicine, Huaidong Du of the University of Oxford, Oxford, United Kingdom and colleagues report that greater consumption of fresh fruit was associated with...
Health
TORONTO Taking high dose folic acid during pregnancy does not prevent pre eclampsia in women at elevated risk for the potentially deadly condition, a Canadian led international study has found. The finding,...
Science
Pre eclampsia is associated with an increased risk of later dementia, particularly vascular dementia, caused by reduced blood supply to the brain due to diseased blood vessels, finds a large study...