RELATIONSHIP BETWEEN HEMOGLOBIN A1C LEVELS IN EARLY PREGNANCY AND ADVERSE OUTCOMES AMONG NON-DIABETIC PATIENTS

Abstract

This study was designed to assess the effects of increased hemoglobin A1c in the first trimester on adverse perinatal outcomes in patients without gestational diabetes mellitus. A prospective study was conducted in the Obstetrics and Gynecology Department of Buch International Hospital Multan from January 2022- January 2023. A total of 160 women with singleton pregnancies in their first trimester and elevated hemoglobin A1c were included in the study. The following outcomes were evaluated in patients: miscarriage, shoulder dystocia, preterm delivery <37 weeks, macrosomia, small or large for gestational age, hypertensive disorders of pregnancy, third- or fourth-degree lacerations, operative vaginal delivery, cesarean delivery, neonatal hypoglycemia, neonatal jaundice, NICU admission, and intrauterine fetal demise. The multivariate analysis evaluated the relationship between hemoglobin A1c and adverse outcomes. The Hb1Ac level in patients ranged from 5.7-6.4%. Elevated levels were noted in elderly patients who were multiparous, obese, and diagnosed with chronic hypertension. 5.6% of patients had a preterm delivery, and 31.2% had a c-section delivery. 7.5% had a likelihood of hypertensive pregnancy disorder, and 10.6% were likely to deliver a macrosomic infant. Based on the results, it can be concluded that elevated hemoglobin A1c levels are significantly associated with preterm birth in patients without gestational diabetes.