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Background and Objectives : This observational study aims to determine the correlation between glycemic control with the HbA1c value and adverse obstetric outcome in women affected by pre-gestational diabetes. Materials and Methods : A retrospective analysis has been performed at the University Hospital of Udine. Only patients with a singleton pregnancy, pre-gestational diabetes, and known level of Hb A1c throughout pregnancy were included in the study. Results : According to the HbA1c level, at the beginning of pregnancy, 49 patients with HbA1c ≤ 7.0% were compared with 45 patients with HbA1c &gt; 7.0%. Maternal age at diagnosis of the disease was significantly higher in the group with HbA1c ≤ 7% than in the group with HbA1c &gt; 7%, 26.00 (18.00-32.00) vs. 20.00 (12.50-27.00). Women with HbA1c ≤ 7.0% reached, at term of pregnancy, significantly lower levels of HbA1c, 5.8% (5.7-6.0) vs. 6.7% (6.3-7.3). Daily insulin units were statistically different between the two groups at the end of pregnancy (47.92 (39.00-67.30) vs. 64.00 (48.00-82.00)). Proteinuria was significantly higher in the group with HbA1c &gt; 7.0%, who delivered at earlier gestational age (37.57 (35.57-38.00) vs. 38.14 (38.00-38.43). Moreover, women with HbA1c &gt; 7.0% had a significantly higher prevalence of an adverse composite outcome. Of note, in multivariate logistic regression analysis, pregnancy complications were significantly correlated to pre-pregnancy HbA1c &gt; 7.0% (OR 2.95 CI.95 1.16-7.48, p &lt; 0.05) independently of age, insulin treatment, and type of diabetes. Conclusions : Our data, obtained from a single-center cohort study, suggest that starting pregnancy with poor glycemic control might predict more complex management of diabetes in the following trimesters.

Is Glycated Hemoglobin A1c Level Associated with Adverse Pregnancy Outcomes of Women Affected by Pre-Gestational Diabetes?