Association between mid-pregnancy HbA1c values and anemia in women without gestational diabetes

Abstract

Abstract Background: Previous studies have examined the association between glycated hemoglobin (HbA1c) and hemoglobin (Hb) levels among non-diabetic people. However, there are no reports relating to the correlation between HbA1c values and anemia in women without gestational diabetes. We, therefore, examined whether there is an association between mid-pregnancy HbA1c values and anemia in women without gestational diabetes. Methods: This retrospective cohort study was conducted at the Affiliated Hospital of Jining Medical University, Jining, China, from January to December 2019. Cases of single pregnancies in women above 18 years old, with recorded HbA1c values at 14-27+6 weeks of gestation, were examined. Women with pregestational diabetes mellitus (GDM) or the development of GDM were excluded. The association between variations in mid-pregnancy HbA1c values and anemia was examined. Results: Among 8553 women without gestational diabetes, univariate analysis results demonstrated a significant positive relationship between (P<.001) mid-pregnancy HbA1c values and anemia, after adjusting for confounding factors. Multivariate piecewise linear regression showed that anemia decreased when HbA1c values were <4.6% (OR 0.40; 95% CI, 0.15-1.04; P=.592) and increased when HbA1c values were was >4.6 % (OR 3.83; 95% CI, 2.95-4.98; P<.0001). Conclusion: This study showed a nonlinear relationship between mid-pregnancy HbA1c values and anemia in women without gestational diabetes. When the HbA1c values increased to the inflection point, they were positively correlated with anemia. Further studies are needed to explore this relationship and the mechanisms involved in the future.