scholarly journals First Trimester Glycated Hemoglobin (HBA1C) Level as a Novel Predictor of Gestational Diabetes Mellitus: a Systematic Review and Meta-Analysis

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Ayers Gilberth Ivano Kalaij ◽  
Nathaniel Gilbert Dyson ◽  
Michael Sugiyanto

Introduction: Gestational diabetes mellitus (GDM) is a severe yet neglected threat to maternal and child health, due to its association with multiple adverse pregnancy outcomes. glycated hemoglobin (HbA1c) level is one of the most promising predictor of GDM in early pregnancy based on several cohort studies done recently. Purpose of study: This systematic review and meta-analysis aims to evaluate the potency of HbA1c level in first trimester as a novel predictor of GDM. Methods: This review selects cohort studies found by database searching systematically using previously determined inclusion, such as pregnant woman as the subject, assess Hb1Ac level in the first trimester, and assess odds ratio towards (GDM), and exclusion criteria such as assess outcome at postpartum, not assess GDM outcomes, and studies written in languages other than English or Bahasa Indonesia. This review was arranged based on PRISMA guideline. Results and Discussion: This review included seven cohort studies with the pooled OR of 4.36 [95%CI: 3.66-5.20]. Quantitative analysis shows that HbA1c level in the first trimester is a significant risk factor of GDM development (p<0.00001). However, heterogeneity analyses revealed substantial heterogeneity are detected in the pooled studies. Therefore, to understand the significance of HbA1c level and the development of GDM, further studies are needed. Conclusion: This study has proven the potency of first trimester HbA1c level as a novel predictor of gestational diabetes mellitus. Thus, it is necessary to integrate the use of HbA1c level screening as part of antenatal care in the first trimester of pregnancy.

2019 ◽  
Vol 57 (10) ◽  
pp. 1435-1449 ◽  
Author(s):  
Paula B. Renz ◽  
Fernando C. Chume ◽  
João R.T. Timm ◽  
Ana L. Pimentel ◽  
Joíza L. Camargo

Abstract Background We conducted a systematic review and meta-analysis to establish the overall accuracy of glycated hemoglobin (HbA1c) in the diagnosis of gestational diabetes mellitus (GDM) diagnosis. Methods We searched MEDLINE, EMBASE, SCOPUS and ClinicalTrials.gov up to October 2018, using keywords related to GDM, HbA1c and diagnosis. Studies were included that were carried out with pregnant women without previous diabetes that assessed the performance of HbA1c (index test) compared to the 75 g oral glucose tolerance test (OGTT) (reference test) for the diagnosis of GDM, that measured HbA1c by standardized methods and presented data necessary for drawing 2 × 2 tables. Results This meta-analysis included eight studies, totaling 6406 pregnant women, of those 1044 had GDM. The diagnostic accuracy of HbA1c was reported at different thresholds ranging from 5.4% (36 mmol/mol) to 6.0% (42 mmol/mol), and the area under the curve (AUC) was 0.825 (95% confidence interval [CI] 0.751–0.899), indicating a good level of overall accuracy. The pooled sensitivities and specificities were 50.3% (95% CI 24.8%–75.7%) and 83.7% (67.5%–92.7%); 24.7% (10.3%–48.5%) and 95.5% (85.7%–98.7%); 10.8% (5.7%–19.41%) and 98.7% (96.2%–99.5%); 12.9% (5.5%–27.5%) and 98.7% (97.6%–99.3%), for the cut-offs of 5.4% (36 mmol/mol), 5.7% (39 mmol/mol), 5.8% (40 mmol/mol) and 6.0% (42 mmol/mol), respectively. Conclusions We observed a high heterogeneity among the studies. The effect of ethnicities, different criteria for OGTT interpretation and the individual performance of HbA1c methods may have contributed to this heterogeneity. The HbA1c test presents high specificity but low sensitivity regardless of the threshold used to diagnose GDM. These findings point to the usefulness of HbA1c as a rule-in test. HbA1c should be used in association with other standard diagnostic tests for GDM diagnosis.


PLoS ONE ◽  
2018 ◽  
Vol 13 (7) ◽  
pp. e0201319 ◽  
Author(s):  
Brittney M. Donovan ◽  
Nichole L. Nidey ◽  
Elizabeth A. Jasper ◽  
Jennifer G. Robinson ◽  
Wei Bao ◽  
...  

2021 ◽  
Author(s):  
Dandan Yan ◽  
Yang Jiao ◽  
Honglin Yan ◽  
Tian Liu ◽  
Hong Yan ◽  
...  

Abstract Objective To conduct a comprehensive systematic review and meta-analysis to estimate the relationship between EDCs, including polychlorinated biphenyls (PCBs), poly-brominated diphenyl ethers (PBDEs), phthalates (PAEs), and per- and polyfluoroalkyl substances (PFAS) exposure and risk of gestational diabetes mellitus (GDM). Methods Relevant literatures were identified by searching Embase, Pubmed, and Web of Science through November 2021. The cohort and case-control studies reporting effect size with 95% confidence intervals (CIs) of EDCs exposure and GDM were selected. The heterogeneity among the included studies were quantified by I2 statistic. Publication bias was evaluated through the Begg’s and Egger’s tests. Results Twenty-five articles with a total of 23, 796 participants were finally identified. The results indicated that exposure to PCBs have a significant impact on the incidence of GDM (OR = 1.14; 95% CI = 1.00-1.31; n = 8). For PBDEs exposure, a positive association was observed for the risk of GDM (OR = 1.32; 95% CI=1.15-1.53; n = 4). Similarly, for PAEs and PFASs exposure, they were also positively associated with the risk of GDM, with summary ORs were 1.10 (95% CI = 1.03-1.16; n = 7 for PAEs) and 1.09 (95% CI = 1.02-1.16; n = 11 for PFASs), respectively. When only included the cohort studies, the summary OR between PCBs exposure and the risk of GDM was 0.99 (95% CI = 0.91-1.09; n = 5). While, for PBDEs, PAEs, and PFASs exposure, the summary ORs from cohort studies were 1.12 (95% CI = 1.00-1.26; n = 2), 1.08 (95% CI =1.02-1.15; n = 5), and 1.06 (95% CI = 1.00-1.12; n = 8), respectively. The Begg’s and Egger’s tests didn’t show publication bias and the sensitivity analyses didn’t change the results in the present meta-analysis. Conclusion These results support the notion that EDCs exposure increases the risk of GDM. Further large-sample epidemiologic researches and mechanistic studies are needed to verify the potential relationship and biological mechanisms. These results are of public health significance since daily EDCs exposure have been expected to increase the risk of GDM development.


2019 ◽  
Author(s):  
Jose Alberto Martínez-Hortelano ◽  
Ivan Cavero Redondo ◽  
Celia Alvarez ◽  
Ana Díez-Fernández ◽  
Montserrat Hernández-Luengo ◽  
...  

2021 ◽  
Vol 38 ◽  
pp. 101016
Author(s):  
Gayathri Delanerolle ◽  
Peter Phiri ◽  
Yutian Zeng ◽  
Kathleen Marston ◽  
Nicola Tempest ◽  
...  

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