Lemaitre M, Ternynck C, Bourry J, et al. - Findings demonstrate an association between increased HbA1c and maternal fetal complications. Persistence of the risk of “large for gestational age (LGA)” was evident for patients with early glycemic imbalance, despite optimization of metabolic balance during the 3rd trimester.

• In this retrospective analysis of pregnancies in 678 type 1 diabetes subjects at Lille Hospital (1997-2019), the link between variations in HbA1c levels and complications was investigated.

• An association was found between higher HbA1c during the first trimester and the CC [composite criterion defined as having at least one of the following complications: prematurity, preeclampsia, LGA, small for gestational age or cesarean section] (odds-ratio (OR), 1.04 per 0.1% increase).

• Higher HbA1c during the third trimester was also found to be related to the CC (OR, 1.07 per 0.1% increase).

• An elevated rate of the CC (OR, 2.81) and an increased rate of LGA (OR, 2.20) was observed in relation to the group defined by an 1st trimester Hba1c > 6.5% (48 mmol/mol) and a 3rd trimester HbA1c <6%.