Hemoglobin A1c levels during pregnancy and risk of autism spectrum disorders in offspring

Xiang AH, Chow T, Martinez MP, Getahun D, Page KA, Buchanan TA, Feldman RK. Hemoglobin A1c Levels During Pregnancy and Risk of Autism Spectrum Disorders in Offspring. JAMA. 2019 Jun 9. doi: 10.1001/jama.2019.8584. [Epub ahead of print]

Maternal preexisting type 1, type 2, or gestational diabetes diagnosed relatively early in pregnancy are associated with increased risk for autism spectrum disorders (ASDs) in offspring.1,2 This study extends previous observations by examining the association between maternal hemoglobin A1c (HbA1c) levels during pregnancy and risk of ASD in offspring....

In this study, there was no association between maternal HbA1c levels during early pregnancy and ASD in offspring when HbA1c levels were analyzed as a continuous variable or as a categorical measure if less than 6.5%. An association with HbA1c levels greater than 6.5% was found but was based on only 15 affected children. These findings are consistent with previous observations and the preconception counseling recommendation to optimize glycemic control with HbA1c levels greater than 6.5%.

These results suggest that maternal glycemic control in early pregnancy may be important for ASD risk in offspring. Study limitations include the lack of information on maternal glycemic control throughout pregnancy, other prenatal and early life risk factors, paternal risk factors, and genetic factors as well as the relatively small sample size for pregnancies with HbA1c levels greater than 6.5%.

Courtesy of:  https://www.mdlinx.com/journal-summaries/hemoglobin-a-sub-1c-sub-pregnancy/2019/08/12/7575097?spec=neurology