HbA1c included in 1st Antenatal Screen

In 2014 the Ministry of Health issued guidelines on ‘Screening, Diagnosis and Management of Gestational Diabetes in New Zealand’.

The guidelines recommended the measurement of HbA1c as part of the 1st antenatal screen. The BOP, Lakes and Waikato DHBs had agreed that HbA1c will become part of the 1st Antenatal screen throughout the regions. The changes came into effect on Monday 16th May 2016. After discussion with interested parties throughout New Zealand the following comments have been appended to HbA1c reports requested as part of the 1st antenatal screen:

“HbA1c ≤ 40: unlikely to have pre-existing glucose intolerance / diabetes but can develop gestational diabetes. Follow local guidelines.”

“HbA1c 41-49: may reflect glucose intolerance. Follow local guidelines or offer 75g oGTT at 24-28 weeks.”

“HbA1c ≥ 50: levels consistent with pre-existing diabetes. Refer to local diabetes in pregnancy service.”

To avoid duplication, we request that HbA1c only be requested as part of the 1st antenatal screen in pregnancy.

HbA1c requested after the 1st antenatal screen will be rejected.