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| HbA1c detection for predicting occurance of gestational diabetes mellitus and pregnancy outcomes of pregnant women |
| Yangxin Maternal and Child Health Care Hospital, Hubei Province, 435200 |
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Abstract Objective: To explore the clinical application value of glycosylated hemoglobin (HbA1c) for predicting occurance of gestational diabetes mellitus (GDM) and pregnancy outcomes of pregnant women. Methods: The clinical data of 130 women with GDM in observation group were retrospectively analyzed. According to the level of HbA1c of women in 36 gestational weeks, the women in the observation group were divided in group A (45 women with HbA1c level less than <6%), group B (49 women with HbA1c level in 6%-7%), and group C (36 women with HbA1c level more than <7%), and another 216 healthy pregnant women were included in group D during the same time. The levels of HbA1c, fasting plasma glucose (FPG) and postprandial 2h glucocortico (2h PG) of women in 20 gestational weeks were compared between the two groups. The receiver operating characteristic curve (ROC) was used to analyze the efficacy for early predictng GDM occurrence of women. The relationship between HbA1c level of women in 36 gestational weeks and their pregnancy outcomes was analyzed. Results: In 20 gestational weeks, the levels of HbA1c, FPG and 2h PG of women in observation group were significant higher than those of women in group D (P<0.05). In the observation group, the AUC of HbA1c level of women in observation group was significant more than that of levels of FPG and 2h PG. The critical points of levels of HbA1c, FPG and 2h PG levels for predicting GDM occuanced in 20 gestational weeks were 5.08%, 4.46mmol/L, and 8.54mmol/L, respectively. The incidences of gestational hypertension, polyhydramnios, macrosomia and fetal intrauterine distress of women in group A were significant higher than those of women in group C (P<0.05), but there was no significant different in the cesarean section rate of women between group A and C (P>0.05). Spearman correlation analysis showed that the HbA1c level of women with GDM in 36 gestational weeks was positively correlated with the incidences of gestational hypertension, polyhydramnios, macrosomia and fetal intrauterine distress (r>0, P<0.05), but was no correlated with the cesarean section rate (P>0.05). Conclusion: The level of HbA1c of pregnant women in 20 gestational weeks can effectively predict the risk of GDM occurance, and the level of HbA1c of pregnant women in 36 gestational weeks can predict pregnancy outcomes. The levels of HbA1c of women in both 20 and 36 gestational weeks can reflect the blood glucose status of pregnant women, which can to provide reliable evidence for early clinical intervention.
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