Elevated preconception glucose levels highest among women with limited access to and use of health care
By Lori Solomon HealthDay Reporter
WEDNESDAY, March 8, 2023 (HealthDay News) — Preconception diabetes or prediabetes is associated with a higher risk for preterm birth, according to a study published online Feb. 16 in the Journal of Womenâs Health.
Erin Delker, Ph.D., M.P.H., from the University of California in San Diego, and colleagues used data from 1,989 women with glucose and hemoglobin A1c (HbA1c) measurements in wave IV (ages 24 to 32 years) of the Add Health study; in wave V (ages 32 to 42 years), women with a live birth reported whether the baby was preterm.
The researchers found that compared with the normoglycemic group, women with diabetes had 2.1 times the risk for preterm birth, while women with prediabetes had 1.3 times the risk for preterm birth. There was a nonlinear relationship observed between HbA1c and preterm birth, with the risk for preterm birth associated with HbA1c of 5.7 percent, a standard cutoff for prediabetes. Among women who reported unstable health care coverage or use of the emergency room as a usual source of care, the excess risks for preterm birth associated with elevated HbA1c were four to five times higher.
“Our findings replicate prior research showing strong associations between preconception diabetes and preterm birth, adding that prediabetes is also associated with higher risk,” the authors write. “Additional monitoring could help identify at-risk women earlier, providing increased opportunities for preconception intervention and substantial benefit to population health.”
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