(942) Antenatal glycated hemoglobin A1c as a predictor of preeclampsia

Medical records of all pregnant individuals who had HbA1c levels obtained during their prenatal care between 2016 and 2018 and delivered at a single tertiary care center were reviewed. HbA1c was drawn at the discretion of the clinician when screening for diabetes was deemed necessary. Individuals with preexisting diabetes were excluded. The primary outcome was a diagnosis of preeclampsia. The first HbA1c was used in the analysis if a patient had more than one drawn. Receiver operator curve (ROC) analysis was performed.  

Results:

A total of 416 participants were eligible for the analysis. Participants had a median age of 30 years, with a median BMI of 33 kg/m² at the time of delivery. Fifty-two patients (12%) had a diagnosis of preeclampsia. Antenatal HbA1c at any trimester was a modest predictor of preeclampsia (AUC: 0.72, 95%CI 0.64-0.79; p< 0.001; Figure 1). When analyzed by trimester of first HbA1c, second trimester HbA1c was found to be a strong predictor of preeclampsia (AUC: 0.91, 95%CI 0.85-0.97; p< 0.001; Figure 1). Second trimester HbA1c > 5.6 had a sensitivity of 88% (95%CI 64%-99%) and specificity of 84% (95%CI 75%-91%), with LR+ of 5.6 and LR- of 0.15. First trimester and third trimester HbA1c were low predictors.

Conclusion:

Second trimester HbA1c is a strong predictor of preeclampsia. Further studies are needed to validate our results.