title: Role of HbA1c in predicting risk for congenital malformations.
abstract: OBJECTIVE
  Association between conventionally identified hyperglycemias and rates of congenital abnormalities is known; however there is less information about role of HbA1c in determining gestational hyperglycemias and associated risks. This study tried to explore the association between HbA1c in women without known diabetes at first antenatal visit and risk of congenital malformations (CM) among Saudi women living at Al-Madinah Al-Monawarah.
  
  
  METHODS
  Eleven hundred and eighty (1180), healthy, first-trimester pregnant Saudi females without known diabetes, were selected from various antenatal care clinics of Al-Madinah Al-Monawarah city. General clinical and biochemical data was collected for this study by researchers at first visit and the time of delivery.
  
  
  RESULTS
  Nearly one fifth (19.6%) of mothers had above normal HbA1c (>5.7) at first visit. Rates of CM had significant positive association with level of HbA1c. Rate of CM among those who had HbA1c in diabetes range, pre-diabetes range or normal range was 27.8%, 9.8% and 3.0%, respectively. The difference was significant between normal and pre-diabetes at the level P=0.000 and between pre-diabetes and diabetes at level P=0.038.
  
  
  CONCLUSIONS
  In this study HbA1c is found to be a valuable predictor of risk of congenital malformations. This observation calls for further studies and establishment of policies for care of pregnant mothers having higher than normal HbA1c at first visit.
authors: Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Taibah University, Assalam Road, Madinah 41412, Saudi Arabia.
authors: Sahar Ali Ibrahim
authors: SA
authors: Hammouda
authors: Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Taibah University, Assalam Road, Madinah 41412, Saudi Arabia. Electronic address: rubina.hakeem@gmail.com.
authors: Rubina
authors: R
authors: Hakeem
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D000013:Congenital Abnormalities / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D016640:Diabetes, Gestational / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008875:Middle Aged; D011236:Prediabetic State / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First / Q000097:blood; D018570:Risk Assessment; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D015854:Up-Regulation; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Congenital malformations; Gestational hyperglycemia; HbA1c; Saudi Arabia