Prediction of birth weight by HbA1c and glucose levels in diabetic pregnant women

Abstract

Objective: To estimate the birth weight by examining the fasting glucose, 1st -hour postprandial glucose, and Hemoglobin A1c levels in pregnant women diagnosed with pregestational diabetes mellitus (PGDM) and gestational diabetes mellitus (GDM) at 28th and 32nd gestational weeks.
 Methods: A total of 105 pregnant women diagnosed with 66 GDM, 39 PGDM (7 of type 1 DM and 32 of type 2 DM) were included in our study. All participants' age, obstetric histories, pre-pregnancy body mass index (BMI), gestational weight gain (GWG), gestational weeks, fasting and 1st-hour postprandial glucose, HbA1c, gestational week at delivery, newborn weight and percentile, and 1st and 5th minute Apgar score were noted.
 Results: Fasting glucose, 1st-hour postprandial glucose, and HbA1c values measured at 28th and 32nd gestational weeks were significantly higher in the PGDM group compared to the GDM group, and the GWG and pre-pregnancy BMI values were similar. ROC curve analysis was used to assess for fasting glucose, 1st-hour postprandial glucose, and GWG predicting large for gestational age (LGA) in the GDM group (AUC: 0.663, %95 CI [0,526, 0,800], AUC: 0.678, %95 CI [0,540, 0,816], AUC: 0.677, %95 CI [0,548, 0,805], respectively). Also, determined to fasting glucose, 1st-hour postprandial glucose, and HbA1c predicting LGA in the PGDM group (AUC: 0.889, %95 CI [0,782, 0,996], AUC: 0.893, %95 CI [0,737, 1,000], AUC: 0.931, %95 CI [0,807, 1,000], respectively).
 Conclusion: Glycemic control is critical in pregnant women with PGDM and GDM. The risk of LGA may be reduced by closely monitoring HbA1c and postprandial glucose in PGDM and postprandial glucose and GWG in GDM. By minimizing fetal overgrowth, the risk of childhood obesity and metabolic syndrome that may develop in the long term may be reduced.