Normal glisemik ve gestasyonel diyabetli hastalarda ilk iki trimester boyunca hemogram parametrelerindeki progresif değişimlerin karşılaştırılması ve bu endekslerin gestasyonel diyabetes mellitusu öngörme yetenekleri

Abstract

Aim: To assess the predictive role of hematological indices in the first trimester of pregnancy for gestational diabetes mellitus (GDM) and to compare the progressive changes in these indices between patients with and without GDM in their first and second trimesters.
 Materials and Methods: Pregnant women screened for GDM in 24-28 gestational weeks and who had CBC test in the first and second trimesters were retrospectively investigated. Platelet mass index (PMI), neutrophil-to-lymphocyte ratios (NLR) and platelet-to-lymphocyte ratios (PLR) were calculated. The first trimester hematological indices were compared between normal glycemic patients and the patients with subsequent GDM. The progressive changes of these indices were compared. 
 Results: Three-hundred-sixty-eight women were enrolled and 17.9% had GDM. There was no difference between first trimester hematological indices, except PLR which was lower in GDM group, however, PLR was not an independent predictor. In normal-glycemic pregnant women hemoglobin, hematocrit, lymphocytes, platelets, mean-platelet-volume (MPV), plateletcrit (PCT), platelet-large-cell-ratio (PLCR) and PMI decreased significantly from first trimester to second trimester. White-blood-cells(WBC), neutrophils, nucleated-red-blood-cells(NRBC), immature granulocytes and NLR increased significantly, while no significant changes were detected in red-cell-distribution-width(RDW), platelet-distribution-width(PDW) and PLR. In GDM patients, hemoglobin, hematocrit, lymphocytes, platelets and PMI significantly decreased while WBC, neutrophils, MPV, immature granulocytes and NLR increased from first trimester to second trimester. RDW, PDW, PCT, PLCR, NRBC and PLR did not change. 
 Conclusion: None of the first trimester hematological indices have a predictive ability for subsequent GDM. The progressive changes in MPV can be used as an indicator to assess the development of GDM.