Glycosylated hemoglobin level at 34 weeks in insulin-controlled diabetic pregnancies, relation to fetal outcome

Abstract

Objective To determine the role of glycosylated hemoglobin at 34 weeks’ gestation and onwards in the prediction of fetal outcome in insulin-controlled diabetic pregnancies. Design Cohort study. Setting Kasr Al-Aini Hospital. Participants and methods A total of 50 singleton pregnant women on insulin treatment with gestational age between 34 and 36 weeks were included. All women underwent ultrasound fetometery, and glycosylated hemoglobin level at 34 weeks, amniotic fluid index, placental maturation, and biophysical profile were determined. Doppler ultrasound was also carried out. Follow-up was carried out for all women until delivery and neonates were examined for body weight, APGAR scoring at 1 and 5 min, and blood glucose level (adverse if <45 mg/dl). Results There was a statistically significant correlation between HbA1c and BMI, amniotic fluid index, and neonatal outcomes. HbA1c of 7 or higher was found to be a cutoff value for the prediction of prematurity, with area under curve of 91.7% (Fig. 2). Conclusion HbA1c may be a useful marker for prematurity in pregnant diabetic women and may correlate with fetal outcome. For the antenatal care of diabetic mothers, it is recommended is to maintain HbA1c less than 7% decrease fetal adverse outcome.