Open AccessA Study on Glycosylated Haemoglobin Values at 6 - 12 Weeks of Pregnancy as an Early Predictor of Gestational Diabetes Mellitus
Author(s) -
Staeny Rex,
Preet Agarwal,
Sarmishta Murugesan,
Rajeshwari K.S
Publication year - 2021
Publication title -
journal of evolution of medical and dental sciences
Language(s) - English
Resource type - Journals
eISSN - 2278-4802
pISSN - 2278-4748
DOI - 10.14260/jemds/2021/508
Subject(s) - medicine , gestational diabetes , obstetrics , pregnancy , diabetes mellitus , postprandial , prospective cohort study , gestational age , outpatient clinic , cohort , gestation , pediatrics , endocrinology , genetics , biology
BACKGROUND Gestational diabetes mellitus (GDM) is a major health problem arising due to insulin resistance in pregnant women. It is associated with multiple maternal complications which may cause end organ failure, complicated labour and delivery and thereby increasing the maternal morbidity and mortality. The foetus is also at risk for problems beginning from in utero and extending into the neonatal period and adult life. We wanted to correlate first trimester HbA1c values with the subsequent development of gestational diabetes mellitus and identify if glycosylated haemoglobin can be used as an adjunct with other screening methods. METHODS It is a prospective cohort study. This study was conducted from August 2015 to August 2017. All women of gestational age 6 to 12 weeks who came to Sri Ramachandra University outpatient department were taken for this study. Informed consent was obtained and a detailed history taking was done as per proforma. Along with routine antenatal investigations, Glycosylated haemoglobin (HbA1c) was also done. Oral Glucose Tolerance Test was to be performed at 24 - 28 weeks as per the World Health Organisation –with 75gm criteria and the results were tabulated and analysed to know the significance of Glycosylated haemoglobin (HbA1c) in the outcome of gestational diabetes mellitus. Further a fasting and postprandial blood sugar was done in the 3rd trimester for all patients as a secondary screening tool for gestational diabetes mellitus. Secondary outcomes of obstetric and neonatal complications were also studied. RESULTS In the present study a total of 323 patients were screened for HbA1c during the first trimester and followed till delivery. Only 21.9 % developed gestational diabetes mellitus. Elevated Glycosylated haemoglobin (HbA1c) value of 5.7 - 6.4 % was seen in 5.9 %. CONCLUSIONS Most of the patients with elevated Glycosylated Haemoglobin in the first trimester had high chance of developing gestational diabetes mellitus. Glycosylated haemoglobin is indeed a simple way of screening, but its solitary use remains controversial and hence could possibly be tried as an adjunct with other screening methods. KEY WORDS Glycosylated Haemoglobin, Gestational Diabetes Mellitus, Glycaemic Control, Maternal and Foetal Morbidity and Mortality