{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T12:42:01Z","timestamp":1793104921148,"version":"4.5.0"},"reference-count":55,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi241047-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Subclinical hyperglycemia before pregnancy may be associated with the likelihood of maternal morbidity but is understudied among young people.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi241047-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To explore the association of preconception hemoglobin A\n                      <jats:sub>1c<\/jats:sub>\n                      (HbA\n                      <jats:sub>1c<\/jats:sub>\n                      ) levels among adolescents and young adults with risk of gestational diabetes at first live birth.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi241047-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study used linked 2009 to 2017 birth registry, hospital discharge, and New York City Department of Health A1C Registry data for birthing individuals aged 10 to 24 years with no history of diabetes and at least 1 preconception HbA\n                      <jats:sub>1c<\/jats:sub>\n                      test in New York, New York. Statistical analysis was performed from August to November 2022.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi241047-7\">\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>\n                      Preconception HbA\n                      <jats:sub>1c<\/jats:sub>\n                      values categorized as no diabetes (HbA\n                      <jats:sub>1c\u2009<\/jats:sub>\n                      &amp;amp;lt;5.7%) or prediabetes (HbA\n                      <jats:sub>1c<\/jats:sub>\n                      \u2009\u22655.7%\u2009to\u2009&amp;amp;lt;6.5%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi241047-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>\n                      The primary outcome was gestational diabetes at first birth. Secondary outcomes included hypertensive disorders of pregnancy, preterm birth, cesarean delivery, and macrosomia. Log binomial regression was used to estimate the relative risk (RR) of gestational diabetes at first birth by preconception HbA\n                      <jats:sub>1c<\/jats:sub>\n                      level, adjusting for prepregnancy characteristics. The optimal HbA\n                      <jats:sub>1c<\/jats:sub>\n                      threshold for gestational diabetes was examined using receiver operating curve regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi241047-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 14\u202f302 individuals (mean [SD] age, 22.10 [1.55] years) met study eligibility criteria. Of these, 5896 (41.0%) were Hispanic, 4149 (29.0%) were Black, 2583 (18.1%) were White, 1516 (10.6%) were Asian, and 185 (1.3%) had other or unknown race and ethnicity. Most (11\u202f407 individuals [79.7%]) had normoglycemia before pregnancy, and 2895 individuals (20.2%) had prediabetes. Adjusting for prepregnancy characteristics, those with preconception prediabetes had more than twice the risk of gestational diabetes vs those with normoglycemia (adjusted RR [aRR], 2.21; 95% CI, 1.91-2.56). Preconception prediabetes was associated with small increases in the likelihood of a hypertensive disorder of pregnancy (aRR, 1.18; 95% CI, 1.03-1.35) and preterm delivery (aRR, 1.18; 95% CI, 1.02-1.37). The aRRs for cesarean delivery (aRR, 1.09; 95% CI, 0.99-1.20) and macrosomia (aRR, 1.13; 95% CI, 0.93-1.37) were increased but not statistically significant. The optimal HbA\n                      <jats:sub>1c<\/jats:sub>\n                      threshold to identify gestational diabetes among adolescents and young adults was 5.6%. The threshold did not vary by obesity status but was slightly lower among Hispanic individuals (HbA\n                      <jats:sub>1c<\/jats:sub>\n                      \u2009of 5.5%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi241047-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>\n                      In this study of adolescents and young adults with at least 1 preconception HbA\n                      <jats:sub>1c<\/jats:sub>\n                      test, prediabetes was associated with increased likelihood of maternal cardiometabolic morbidity at first birth. Efforts to optimize cardiometabolic health before pregnancy may avert excess maternal risk.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.35136","type":"journal-article","created":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T11:00:47Z","timestamp":1727175647000},"page":"e2435136","source":"Crossref","is-referenced-by-count":11,"title":["Preconception HbA\n                    <sub>1c<\/sub>\n                    Levels in Adolescents and Young Adults and Adverse Birth Outcomes"],"prefix":"10.1001","volume":"7","author":[{"given":"Katharine J.","family":"McCarthy","sequence":"first","affiliation":[{"name":"Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York"},{"name":"Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelley H.","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Department of Health and Mental Hygiene, Bureau of Vital Statistics, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiu Tai","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Health and Mental Hygiene, Bureau of Vital Statistics, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances","family":"Howell","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Boychuk","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria L.","family":"Mayer","sequence":"additional","affiliation":[{"name":"Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York"},{"name":"Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciana","family":"Vieira","sequence":"additional","affiliation":[{"name":"Department of Maternal and Fetal Medicine, Stamford Hospital, Stamford, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bahman","family":"Tabaei","sequence":"additional","affiliation":[{"name":"Department of Health and Mental Hygiene, Bureau of Health Equity, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kacie","family":"Seil","sequence":"additional","affiliation":[{"name":"Department of Health and Mental Hygiene, Bureau of Vital Statistics, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gretchen","family":"Van Wye","sequence":"additional","affiliation":[{"name":"Department of Health and Mental Hygiene, Bureau of Vital Statistics, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Janevic","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2024,9,24]]},"reference":[{"key":"zoi241047r1","doi-asserted-by":"publisher","first-page":"S14","DOI":"10.2337\/dc20-S002","article-title":"2. 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