Peri-Conceptional A1C and Risk of Serious Adverse Pregnancy Outcome in 933 Women With Type 1 Diabetes
Abstract
OBJECTIVE To study the association between peri-conceptional A1C and serious adverse pregnancy outcome (congenital malformations and perinatal mortality).
RESEARCH DESIGN AND METHODS Prospective data were collected in 933 singleton pregnancies complicated by type 1 diabetes.
RESULTS The risk of serious adverse outcome at different A1C levels was compared with the background population. The risk was significantly higher when peri-conceptional A1C exceeded 6.9%, and the risk tended to increase gradually with increasing A1C. Women with A1C exceeding 10.4% had a very high risk of 16%. Congenital malformation rate increased significantly at A1C above 10.4%, whereas perinatal mortality was increased even at A1C below 6.9%.
CONCLUSIONS These results support recent guidelines of preconceptional A1C levels <7% in women with type 1 diabetes.
Footnotes
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- Received November 15, 2008.
- Accepted February 26, 2009.
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- © 2009 by the American Diabetes Association.