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High pre-pregnancy glucose levels in pregnancy could lead to complications

High blood sugar levels have been linked to poor pregnancy outcomes, even among women who do not have diabetes, according to researchers.

In 2007 a Canadian team started a new study which would look at the association between HbA1c levels and severe maternal morbidity (SMM), a term used to refer to any physical, mental illness or disability directly related to pregnancy and/or childbirth.

For eight years they studied data from more than 30,000 women aged between 16 and 50, 90 per cent of whom did not have diabetes, to see if they could find a pattern.

The researchers, from the University of Toronto, found the risk of SMM, or death from 23 weeks’ gestation to 6 weeks postpartum was 2.2 per cent.

They found that for every 0.5 per cent increase in HbA1c levels, the risk of SMM or death went up by 1.16.

Compared to those with average glucose levels below 5.8 per cent, the SMM risk was 1.31. But in women who had not been diagnosed with diabetes, but their HbA1c levels were over 6.4 per cent, their risk of SMM was recorded at 3.25.

The researchers said: “Our findings indicate that women with an elevated A1c (HbA1c levels) preconception may be at higher risk of SMM or death in pregnancy or postpartum, including those without known pre-pregnancy diabetes.”

However, the study did not allow for recording 77 per cent of the participants’ pre-pregnancy body mass index, therefore the research team is unable to say whether the woman’s between BMI impacted their glucose levels.

Despite that, the researchers think these early findings indicate more work should be done at exploring HbA1c levels and SMM.

The authors added: “Given its convenient and widespread use, A1c testing may identify those women with pre-existing diabetes mellitus at risk of severe maternal mortality, in a manner similar to its current use in recognising those at higher risk of foetal anomalies, preterm birth and pre-eclampsia.

“As there is no current recommendation about A1c testing in nondiabetic pregnant women, especially those with obesity and/or chronic hypertension, our findings may enhance research about the benefits of A1c screening in these women.”

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