Early pregnancy glycosylated hemoglobin, severity of diabetes, and fetal malformations

Michael J. Lucas, Kenneth J Leveno, M. Lynne Williams, Philip Raskin, Peggy J Whalley

Research output: Contribution to journalArticlepeer-review

100 Scopus citations


Total percent glycosylated hemoglobin (A1a + b + c) was measured before 16 weeks' gestation in 105 insulin-treated diabetic women enrolled for prenatal care at Parkland Memorial Hospital. Seventy-three of the infants were normal, 14 had malformations, and there were 18 spontaneous abortions. The mean glycosylated hemoglobin level for the entire study group was 9.2%, compared with 9.4% for those pregnancies ending in abortion, 8.9% for those resulting in normal infants, and 10.3% when malformations occurred. The mean glycosylated hemoglobin value for women delivered of normal infants was significantly lower than the mean of those with malformed infants. Ten of the 14 malformations occurred in mothers whose early pregnancy values exceeded the mean of the entire study group. There was also an association between malformations and White classification of maternal diabetes since 10 of the 14 fetal anomalies occurred in women assigned to White Classes C, D, F, H, and R. When the distribution of malformations was analyzed according to both glycosylated hemoglobin level and White Class, there was evidence of an interaction to suggest that hyperglycemia increases the relative risk of fetal malformations when associated with maternal diabetes of longer duration and/or with vascular complications.

Original languageEnglish (US)
Pages (from-to)426-431
Number of pages6
JournalAmerican journal of obstetrics and gynecology
Issue number2
StatePublished - Aug 1989


  • Glycosylated hemoglobin
  • diabetic pregnancy
  • malformations

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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