Peri-conceptional A1C and risk of serious adverse pregnancy outcome in 933 women with type 1 diabetes.
OBJECTIVE
To study the association between peri-conceptional A1C and serious adverse pregnancy outcome (congenital malformations and perinatal mortality).


METHODS
Prospective data were collected in 933 singleton pregnancies complicated by type 1 diabetes.


RESULTS
The risk of serious adverse outcome at different A1C levels was compared with the background population. The risk was significantly higher when peri-conceptional A1C exceeded 6.9%, and the risk tended to increase gradually with increasing A1C. Women with A1C exceeding 10.4% had a very high risk of 16%. Congenital malformation rate increased significantly at A1C above 10.4%, whereas perinatal mortality was increased even at A1C below 6.9%.


CONCLUSIONS
These results support recent guidelines of preconceptional A1C levels <7% in women with type 1 diabetes.
Jensen
Dorte M
DM
Department of Endocrinology, Odense University Hospital, University of Southern Denmark, Odense, Denmark. dortemj@dadlnet.dk
Korsholm
Lars
L
Ovesen
Per
P
Beck-Nielsen
Henning
H
Moelsted-Pedersen
Lars
L
Westergaard
Jes G
JG
Moeller
Margrethe
M
Damm
Peter
P
D015992:Body Mass Index; D002869:Chromosome Aberrations / Q000706:statistics & numerical data*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007231:Infant, Newborn; D054238:Perinatal Mortality; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011446:Prospective Studies; D012189:Retrospective Studies; D044465:White People
D006442:Glycated Hemoglobin