{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T01:50:39Z","timestamp":1773971439496,"version":"3.50.1"},"reference-count":18,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,12,12]],"date-time":"2022-12-12T00:00:00Z","timestamp":1670803200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001626","name":"Public Health Agency","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001626","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2023,2]]},"abstract":"Abstract<\/jats:title>Objective<\/jats:title>Gestational diabetes mellitus (GDM) is associated with excessive fetal growth in later gestation.<\/jats:p>Recent data suggest accelerated growth may begin before 28\u2009weeks' gestation when GDM is typically diagnosed. The identification of pregnancies at risk of early fetal growth would enable early intervention. We assessed the use of early pregnancy HbA1c in predicting excessive fetal growth.<\/jats:p><\/jats:sec>Research Design and Methods<\/jats:title>Women were recruited at antenatal booking from a major maternity unit in the UK. HbA1c was measured at <14\u2009weeks gestation in 1243 women at risk of GDM as defined by UK NICE risk factors of whom 1115 underwent OGTT. Women with previous GDM were excluded. Comprehensive fetal ultrasound was performed at 28\u2009weeks' gestation alongside 75\u2009g OGTT in 976 of these women. GDM was defined using WHO criteria. Pregnancy outcomes were extracted from the regional maternity care database.<\/jats:p><\/jats:sec>Results<\/jats:title>Two hundred and thirty\u2010six women screened positive for GDM. At diagnosis, GDM pregnancies demonstrated higher adjusted fetal weight percentile than non\u2010GDM pregnancies: (51.8 vs. 46.3, p<\/jats:italic>\u00a0=\u00a00.008). This was driven by increases in the fetal abdominal circumference percentile in GDM compared with non\u2010GDM pregnancies (55.3 vs. 46.2, p<\/jats:italic>\u00a0=\u00a0<0.001). Early pregnancy HbA1c was higher in the GDM versus non\u2010GDM group: (35.7\u2009mmol\/mol vs. 32.9\u2009mmol\/mol p<\/jats:italic>\u00a0=\u00a0<0.01). A threshold for predicting excessive fetal growth was not identified in this cohort.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Accelerated fetal growth is evident prior to the diagnosis of GDM. There remains a need for suitable methods of early identification of pregnancies at high risk for early accelerated fetal growth due to GDM. First\u2010trimester HbA1c was not useful in identifying these pregnancies.<\/jats:p><\/jats:sec>Novelty Statement<\/jats:title><\/jats:sec>What is already known?<\/jats:title>\n\n\nRecent research suggests excessive growth associated with GDM may begin prior to 28\u2009weeks' gestation, when GDM is typically tested for<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec>What this study has found?<\/jats:title>\n\n\nPregnancies affected by GDM are already subject to accelerated fetal growth in comparison to non\u2010GDM pregnancies by way of higher estimated fetal weight and fetal abdominal circumference<\/jats:p><\/jats:list-item>\n\nNeither first\u2010trimester HbA1c nor plasma glucose was useful predictors of these outcomes<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec>What are the implications of this study?<\/jats:title>\n\n\nHighlights the emergence of excessive growth prior to detection of GDM<\/jats:styled-content><\/jats:p><\/jats:list-item>\n<\/jats:list>\n\n\nReinforces need for suitable methods of identifying such pregnancies in earlier gestation<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.15019","type":"journal-article","created":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T15:06:31Z","timestamp":1669907191000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["First\u2010trimester glycaemic markers as predictors of gestational diabetes and its associated adverse outcomes: A prospective cohort study"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9455-4693","authenticated-orcid":false,"given":"Robert J.","family":"D'Arcy","sequence":"first","affiliation":[{"name":"Regional Centre for Endocrinology Royal Victoria Hospital Belfast UK"},{"name":"Centre for Public Health Queens University Belfast UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inez E.","family":"Cooke","sequence":"additional","affiliation":[{"name":"Royal Jubilee Maternity Service Belfast UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"McKinley","sequence":"additional","affiliation":[{"name":"Centre for Public Health Queens University Belfast UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David R.","family":"McCance","sequence":"additional","affiliation":[{"name":"Regional Centre for Endocrinology Royal Victoria Hospital Belfast UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Una M.","family":"Graham","sequence":"additional","affiliation":[{"name":"Regional Centre for Endocrinology Royal Victoria Hospital Belfast UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,12,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-0160"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc14-1312"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12166"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12519"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2015.04.027"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.06.016"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2017.08.019"},{"key":"e_1_2_9_9_1","volume-title":"Guidance for Maternal Medicine Services in the Evolving Coronavirus (COVID\u201019) Pandemic","author":"Royal College of Obstetricians and Gynaecologists","year":"2020"},{"key":"e_1_2_9_10_1","unstructured":"YamamotoJ. M.et al.Urgent Update\u2010Temporary Alternative Screening Strategy for Gestational Diabetes Screening during the COVID\u201019 Pandemic A Joint Consensus Statement from the Diabetes Canada Clinical Practice Guidelines Steering Committee* and the Society of Obstetricians and Gynecologists of Canada."},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2020.108353"},{"key":"e_1_2_9_12_1","unstructured":"National Institute for Health and Care Excellence.N. Overview | Diabetes in pregnancy: management from preconception to the postnatal period | Guidance | NICE.https:\/\/www.nice.org.uk\/guidance\/ng3"},{"key":"e_1_2_9_13_1","unstructured":"WHO.WHO | Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy.https:\/\/www.who.int\/diabetes\/publications\/Hyperglycaemia_In_Pregnancy\/en\/"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.181.1.1887021"},{"key":"e_1_2_9_15_1","unstructured":"Perinatal Institute: FetalGrowth.https:\/\/www.perinatal.org.uk\/FetalGrowth\/home"},{"key":"e_1_2_9_16_1","unstructured":"Northern Ireland Statistics and Research Agency.Northern Ireland Census STATISTICS BULLETIN.https:\/\/www.nisra.gov.uk\/sites\/nisra.gov.uk\/files\/publications\/2011\u2010census\u2010results\u2010detailed\u2010characteristics\u2010statistics\u2010bulletin\u201028\u2010june\u20102013.pdf(2013)."},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-0244"},{"key":"e_1_2_9_18_1","first-page":"2016","article-title":"Role of first trimester HbA1c as a predictor of adverse obstetric outcomes in a multi\u2010ethnic cohort","volume":"102","author":"Ma\u00f1\u00e9 L.","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-1687"}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.15019","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dme.15019","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.15019","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,16]],"date-time":"2024-03-16T07:03:41Z","timestamp":1710572621000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dme.15019"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,12]]},"references-count":18,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,2]]}},"alternative-id":["10.1111\/dme.15019"],"URL":"https:\/\/doi.org\/10.1111\/dme.15019","archive":["Portico"],"relation":{},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"value":"0742-3071","type":"print"},{"value":"1464-5491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,12]]},"assertion":[{"value":"2022-06-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e15019"}}