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Research Letter
June 9, 2019

Hemoglobin A1c Levels During Pregnancy and Risk of Autism Spectrum Disorders in Offspring

Author Affiliations
  • 1Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena
  • 2Division of Endocrinology and Diabetes, University of Southern California Keck School of Medicine, Los Angeles
  • 3Obstetrics and Gynecology, Kaiser Permanente Southern California, Pasadena
JAMA. 2019;322(5):460-461. doi:10.1001/jama.2019.8584

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.

This retrospective cohort study included singleton children born at 28 to 44 weeks’ gestation in Kaiser Permanente Southern California (KPSC) hospitals between January 1, 2012, and December 31, 2013. KPSC implemented HbA1c screening in the early prenatal period for all pregnancies starting in 2012. Children who enrolled as KPSC health plan members at age 1 year were tracked through electronic medical records until the first of the following: (1) clinical diagnosis of ASD with at least 1 diagnostic code, (2) last date of continuous KPSC membership, (3) death, or (4) study end date of December 31, 2017. The KPSC institutional review board approved this study and provided waiver of participant consent.