{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T14:07:52Z","timestamp":1794319672481,"version":"4.9.0"},"reference-count":40,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,3,8]],"date-time":"2022-03-08T00:00:00Z","timestamp":1646697600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2022,7]]},"abstract":"Abstract<\/jats:title>\n \n Aims<\/jats:title>\n \n To determine whether a net decline in glycosylated haemoglobin (HbA\n 1c<\/jats:sub>\n ) from early to late pregnancy is associated with lower risk of adverse perinatal outcomes at delivery among women with pregestational diabetes.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A retrospective analysis from 2012 to 2016 at a tertiary care centre. The exposure was the net change in HbA\n 1c<\/jats:sub>\n from early (<20\u00a0weeks gestation) to late pregnancy (\u226520\u00a0weeks gestation). Primary outcomes were large for gestational age (LGA) and neonatal hypoglycaemia. The association between outcomes per 6\u00a0mmol\/mol (0.5%) absolute decrease in HbA\n 1c<\/jats:sub>\n was evaluated using modified Poisson regression, and adjusted for age, body mass index, White Class, early HbA\n 1c<\/jats:sub>\n and haemoglobin and gestational age at HbA\n 1c<\/jats:sub>\n measurement and delivery.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 347 women with pregestational diabetes, HbA\n 1c<\/jats:sub>\n was assessed in early (9\u00a0weeks [IQR 7,13]) and late pregnancy (31\u00a0weeks [IQR 29,34]). Mean HbA\n 1c<\/jats:sub>\n decreased from early (59\u00a0mmol\/mol [7.5%]) to late (47\u00a0mmol\/mol [6.5%]) pregnancy. Each 6\u00a0mmol\/mol (0.5%) absolute decrease in HbA\n 1c<\/jats:sub>\n was associated with a 12% reduced risk of LGA infant (30%, aRR:0.88; 95% CI:0.81,0.95), and a 7% reduced risk of neonatal hypoglycaemia (35%, aRR:0.93; 95% CI:0.87,0.99). Preterm birth (36%, aRR:0.93; 95% CI:0.89,0.98) and neonatal intensive care unit admission (55%, aRR:0.95; 95% CI:0.91,0.98) decreased with a net decline in HbA\n 1c<\/jats:sub>\n , but not caesarean delivery, pre\u2010eclampsia, shoulder dystocia and respiratory distress syndrome.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Women with pregestational diabetes with a reduction in HbA\n 1c<\/jats:sub>\n may have fewer infants born LGA or with neonatal hypoglycaemia. Repeated assessment of HbA\n 1c<\/jats:sub>\n may provide an additional measure of glycaemic control.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/dme.14822","type":"journal-article","created":{"date-parts":[[2022,3,9]],"date-time":"2022-03-09T00:11:38Z","timestamp":1646784698000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Association of change in haemoglobin A1c with adverse perinatal outcomes in women with pregestational diabetes"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7663-3774","authenticated-orcid":false,"given":"Miranda K.","family":"Kiefer","sequence":"first","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine Department of Obstetrics and Gynecology The Ohio State University Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew M.","family":"Finneran","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine Department of Obstetrics and Gynecology Medical University of South Carolina Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney A.","family":"Ware","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine Department of Obstetrics and Gynecology The Ohio State University Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naleef","family":"Fareed","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics The Ohio State University Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Joseph","sequence":"additional","affiliation":[{"name":"Division of Endocrinology Department of Medicine The Ohio State University Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen 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