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This is an observational study at the Obstetrical outpatient clinic at Stavanger University Hospital, Norway. The purpose of the study is to compare glycated albumin and glycated hemoglobin (HbA1c), both markers of "long-term blood sugar" with oral glucose tolerance test (OGTT). The OGTT is a screening test for gestational diabetes, a condition that increases risk of adverse pregnancy outcome for mother and child. The risks are reduced with good glycaemic control throughout pregnancy, therefore, it is important to screen for gestational diabetes.
According to the new guideline by the Norwegian Directorate of Health published april 2017, screening for gestational diabetes is increased. All pregnant women with a slight risk, approximately 70 % of pregnant women i Norway, should have an OGTT performed in gestational week 24-28. Among those women, all primiparas above the age of 25 years old.
The investigators will include 150 primiparas above the age of 25 years old in the study. The women will be asked to participate in the study when they attend an ultrasound examination at the Obstetric outpatient clinic in gestational week 18-20. Prior to inclusion, participants need to sign written informed consent.
Included women will get an appointment for OGTT in gestational week 24-28 at the Clinical trial unit, Stavanger University hospital. The OGTT will be performed according to national guidelines. The participants will fill in a single questionaire with information on age, height, ethnicity, whether there is diabetes in close family, any other illnesses, smoking habits and other medications/supplements.
In addition, to blood sugar levels, markers of importance for glycaemic control, iron status and vitamin-D status will be analyzed.
Women diagnosed with gestational diabetes or overt diabetes mellitus, will be followed up according to national guidelines.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Pregnant women | Primiparas above 25 years of age, singleton pregnancy |
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| Measure | Description | Time Frame |
|---|---|---|
| Glycated albumin reference interval in pregnancy | Glycated albumin will be analyzed by a new method based on mass spectrometry. Glycated albumin will be analyzed in blood samples taken during the OGTT. | gestational week 24-28 |
| Measure | Description | Time Frame |
|---|---|---|
| Oral glucose tolerance test in pregnancy | The oral glucose tolerance test (OGTT) will be performed according to national guidelines as a screening test for gestational diabetes | Gestational week 24-28 |
| HbA1c |
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Inclusion Criteria:
Exclusion criteria:
- prior diagnosed with diabetes
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Primiparas above the age of 25 years old at conception. Women will be asked to participate in the study when they atttend an ultrasound examination at the Obstetrical outpatient clinic, Stavanger University Hospital, in gestational week 18-20.
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| Name | Affiliation | Role |
|---|---|---|
| Johanne H Toft, MD | Helse Stavanger HF | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Stavanger University hospital | Stavanger | Rogaland | 4068 | Norway |
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| ID | Term |
|---|---|
| D016640 | Diabetes, Gestational |
| ID | Term |
|---|---|
| D011248 | Pregnancy Complications |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D003920 | Diabetes Mellitus |
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Blood samples
HbA1c, long-term bloodsugar, will be analyzed in blood sample taken during the OGTT for all participants
| Gestational week 24-28 |
| Iron status | Iron status might effect the HbA1c Level. We will analyse iron status in blood samples collected at the OGTT for all participants. | Gestational week 24-28 |
| Glycaemic control | For women diagnosed with gestational diabetes, we will register blood sugar measurements from diagnosis until gestational week 37. These measurements will be compared to HbA1c and glycated albumin levels in blood sample taken in gestational week 37 | Gestational week 24-37 |
| Preeclampsia | Pregnancy outcome. New onset systolic blood pressure >140, diastolic blood pressure >90 after gestational week 20 and proteinuria 2+ according to urine dipstick, will be registered as preeclampsia | From gestational week 20 until 1 week postpartum |
| Induction of labour | Register pregnancy outcome. Induction of Labour and indication for induction will be registered. | At delivery |
| APGAR | Register pregnancy outcome. APGAR score (Appearance, Pulse, Grimace, Activity, Respiration) of the newborn will be registered for 1 minute, 5 minute and 10 minutes after delivery. | At delivery |
| Birth weight | Register pregnancy outcome. Birth weight (gram) of the newborn will be registered | At delivery |
| Admission to neonatal intensive care unit | Register pregnancy outcome. Admission to neonatal intensive care unit will be registered. | At delivery |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |