Glycated hemoglobin in early pregnancy as a predictor of gestational diabetes mellitus

Abstract

Introduction: The prevalence of Gestational diabetes mellitus (GDM) is high in Asian subcontinent. As per current guidelines, the routine screening for GDM is at 24 to 28 weeks of gestation.30 to 50% of GDM cases may remain undiagnosed until such period of screening. This study aims to investigate HbA1C levels at as early as 12 weeks of pregnancy as a predictor of GDM. Materials and Methods: This prospective study included 100 patients enrolled at their first antenatal visit, or before 12 weeks of gestational age, who attended OPD. At the time of enrolment for HbA1c and routine antenatal investigations were done. A 75 gm GTT was done at 22 to 26 weeks of gestation. HbA1c cutoff was taken as ?5.7 & ?6.4 and patients having value ?5.7 were taken as abnormal. Subjects with HbA1c ?6.5, overt diabetes, hemoglobinopathies, anaemia, chronic renal diseases and multiple pregnancies were excluded from the study. Results: It is found that women >28 years had higher levels of hbA1C in comparison to patients Conclusion: The study concludes that women with higher HbA1c (?5.7) were more likely to develop GDM than those women with lower HbA1C (?5.7). HbA1c can be done routinely in early pregnancy (1st trimester). Women with higher HbA1c (?5.7) can benefit from early interventions early in pregnancy thereby prevent GDM and adverse perinatal and pregnancy outcomes. Keywords: Early pregnancy, Glycated hemoglobin, GDM, Maternal age.