The link between Hba1c and macrosomia or LGA in GDM and the risk of preterm birth in women with diabetes mellitus

The rising prevalence of diabetes in pregnancy is a cause for concern, with numerous adverse outcomes for both mother and baby. In particular, the delivery of a large baby (macrosomia) and preterm delivery are significant complications. 

Mou SS conducted two systematic reviews to identify current knowledge about macrosomia and preterm birth in pregnancies complicated by diabetes.

The first review found a significant association between high HbA1c levels and fetal macrosomia in pregnancies with gestational diabetes. Mothers with high HbA1c levels are at increased risk of delivering a macrosomic or large for a gestational-age baby. This emphasizes the importance of strict glycaemic control during pregnancy. Medications and advice on healthy weight gain can be beneficial for mothers with gestational diabetes.

The second review recognized a higher risk of preterm delivery in diabetic pregnancies than in normal pregnancies. The risk of preterm delivery appeared highest in type 1 diabetes mellitus, followed by type 2 diabetes mellitus and gestational diabetes. Maintaining strict glycaemic control before and during pregnancy, regular blood glucose checks, and maintaining healthy weight gain are important for mothers already classed as having diabetes before pregnancy.

This study highlights that achieving good glycaemic control is crucial to prevent adverse outcomes in women with diabetes during pregnancy. The ultimate goal is delivering a healthy, full-term baby to break the vicious cycle of diabetes and reduce the burden of the disease globally.

These reviews also underscore the importance of education and interventions to promote healthy pregnancies in women with diabetes. Healthcare providers should prioritize educating mothers with diabetes on the importance of good glycaemic control and healthy weight gain. Future research should also investigate strategies to prevent adverse outcomes in diabetic pregnancies. Addressing these issues can improve the health outcomes for mothers and babies in diabetic pregnancies.

Mou SS. The Association Between Hba1c with Macrosomia/Large for Gestational Age in GDM; and Preterm Birth in Women with Diabetes Mellitus. The University of Leicester. Thesis. 2023. https://doi.org/10.25392/leicester.data.21960041.v1