Increased Hemoglobin A1c in Obese Pregnant Women after Exclusion of Gestational Diabetes

To the Editor:Preconception obesity is a strong predictor of glucose intolerance during pregnancy that has the potential to lead to adverse maternal and offspring effects. An increased prevalence of overweight offspring of obese mothers has been reported, despite normal values in an oral glucose tolerance test (OGTT)1 during pregnancy (1). Such findings might reflect effects of the intrauterine milieu, genetic background, or lifestyle factors related to maternal obesity or, alternatively, failure to diagnose glucose intolerance in obese pregnant women. We investigated whether increases in hemoglobin A1c (Hb A1c) at delivery as a surrogate marker of glycometabolic disturbances are prevalent in obese mothers, despite the exclusion of gestational diabetes (GDM) even after applying the stringent new criteria as recommended by the International Association of Diabetes and Pregnancy Study Groups (IADPSG).We performed a retrospective analysis of 137 obese pregnant Caucasian women. Recruitment was through an ongoing cohort study on the long-term effects of preconception maternal obesity (PEACHES, Programming of Enhanced Adiposity Risk in CHildhood – Early Screening), which had been initiated in 15 recruiting maternity clinics in Bavaria, Germany. Inclusion criteria before delivery were an age ≥18 years, singleton pregnancy, full-term birth, and a pregestation body mass index (BMI) ≥30 kg/m2. Women with a preexisting diagnosis …