HbA1c level in last trimester pregnancy in predicting macrosomia and hypoglycemia in neonate

Abstract

Background:The usefulness of single value of HbAlc during last trimester in pregnancies complicated by diabetes either pre-existing or gestational diabetes in predicting macrosomia and neonatal hypoglycemia is investigated. The aim of the study was to anticipate and manage the difficult labor due to macrosomia and to monitor these high risk newborns closely for hypoglycemia thereby preventing the neonatal morbidity.Methods: A Prospective observational study of 96 mothers was done for a period of one year from June 2012 to September 2013 in a tertiary care centre. HbAlc level was estimated as one time blood test in the last trimester of pregnancy. At delivery anthropometric measurements of the baby were recorded and an intra-uterine growth chart was used to check whether the baby is macrosomic or not. Any difficult or non-progression of labor and ceaserian section details are recorded. Macrosomia is birth weight more than 90th percentile for the gestational age. Hypoglycemia occurs when blood sugar level found to be <40 mg/dl at 3 hours of life. Chi square test is used to see the correlation between HbAlC and macrosomia and hypoglycemia. Results:20 babies had macrosomia and 22.9% of them had hypoglycemia. HbAlc <5.7 is defined as normal and HbAlc > 5.7% as abnormal. Mothers with abnormal HbAlc levels had a statistically significant correlation (P <0.001) to occurrence of Macrosomia and hypoglycemia in babies.Conclusions:An abnormal HbAlc in third trimester in pregnancies complicated by diabetes can predict Macrosomia and hypoglycemia in the neonates.