Hyperglycemia During Pregnancy: Risks and Findings

Hyperglycemia during pregnancy poses risks to both mothers and infants, necessitating vigilant monitoring. A recent study, a secondary analysis of the AMANHI cohort, investigates the correlation between early to mid-pregnancy HbA1c levels and pregnancy complications in three South Asian and Sub-Saharan African countries. Elevated maternal HbA1c levels emerged as an independent risk factor for adverse pregnancy outcomes in South Asia and Sub-Saharan Africa.

This study was published in the journal BMC Pregnancy and Childbirth by Muhammad Imran Nisar and colleagues. The AMANHI cohort enrolled 10,001 pregnant women across Bangladesh, Pakistan, and Tanzania between May 2014 and June 2018. HbA1c assays were conducted during the early gestational period, and epidemiological data were collected throughout pregnancy. Maternal outcomes were tracked, with a focus on adverse events.

Key Findings

• Among 9,510 pregnant women analyzed, mean HbA1c levels varied across regions:
  • Bangladesh: 5.31 ± 0.37
  • Tanzania: 5.22 ± 0.49
  • Pakistan: 5.07 ± 0.58
• The multivariate analysis revealed that maternal HbA1c levels ≥ 6.5 were independently associated with increased risks of:
  • Stillbirths (aRR = 6.3, 95% CI = 3.4,11.6)
  • Preterm births (aRR = 3.5, 95% CI = 1.8–6.7)
  • Large for Gestational Age (aRR = 5.5, 95% CI = 2.9–10.6)
• These findings advocate for early interventions to mitigate risks in these regions.

In conclusion, elevated maternal HbA1c levels during early to mid-pregnancy pose a significant risk for adverse outcomes, including stillbirths, preterm births, and Large for Gestational Age babies, in South Asian and Sub-Saharan African populations. These findings highlight the importance of early monitoring and intervention strategies to mitigate these risks and improve maternal and fetal health outcomes.

Reference

Nisar, M. I., Das, S., Khanam, R., Khalid, J., Chetia, S., Hasan, T., Shahid, S., Marijani, M. L., Ahmed, S., Khalid, F., Ali, S. M., Chowdhury, N. H., Mehmood, U., Dutta, A., Rahman, S., Qazi, M. F., Deb, S., Mitra, D. K., Usmani, A. A., … Jehan, F. Early to mid-pregnancy HbA1c levels and its association with adverse pregnancy outcomes in three low middle-income countries in Asia and Sub-Saharan Africa. BMC Pregnancy and Childbirth, 2024;24(1). https://doi.org/10.1186/s12884-023-06241-w