A RECENT study has found that adolescents and young adults with preconception prediabetes are at a significantly higher risk of developing gestational diabetes and other adverse birth outcomes. The cohort study analysed data from 14,302 young individuals aged 10 to 24 in New York City, focusing on the impact of preconception haemoglobin A1c (HbA1c) levels on maternal and neonatal health during their first live birth.
The study revealed that individuals with prediabetes (defined as an HbA1c level of 5.7% to less than 6.5%) had more than twice the risk of developing gestational diabetes compared to those with normal HbA1c levels. Additionally, prediabetes was associated with an 18% increased risk of both hypertensive disorders of pregnancy and preterm delivery. Although there were slight increases in the risk of caesarean delivery and macrosomia, these findings were not statistically significant.
These results highlight adolescence and early adulthood as critical periods for addressing cardiometabolic health. By optimising HbA1c levels before pregnancy, healthcare professionals may help reduce the risk of serious maternal and neonatal complications. The study suggests that efforts to monitor and improve preconception health could play a crucial role in preventing gestational diabetes and related adverse outcomes.
This research emphasises the importance of early intervention and routine HbA1c testing in young people, particularly in populations with a higher prevalence of prediabetes. Identifying and managing prediabetes before conception could lead to better maternal and child health outcomes, reducing the burden of gestational diabetes and associated complications.
Aleksandra Zurowska, EMJ
Reference
McCarthy KJ et al. Preconception HbA1c Levels in Adolescents and Young Adults and Adverse Birth Outcomes. JAMA Netw Open. 2024;7(9):e2435136.
