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| Correlation between HbA1c level of pregnant women with gestational diabetes mellitus and maternal BMI, neonatal weight, and pregnancy outcomes |
| Shanghai Ninth People’s Hospital affiliated to Shanghai Jiaotong University School of medicine, Shanghai, 201900 |
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Abstract To analyze the correlation between glycosylated hemoglobin (HbA1c) level of pregnant women with gestational diabetes mellitus (GDM) during the third trimester of pregnancy and their body mass index (BMI) before delivery, neonatal weight, and their adverse pregnancy outcomes. Methods: The related data of pregnant women with GDM who established cards and gave birth and their newborns were collected retrospectively. According to the average level of HbA1c during the third trimester of pregnancy, these women were divided into three groups, including 64 cases with HbA1c<5.5% in group A, 32 cases with 5.5%≤HbA1c<6.0% in group B, and 69 cases with HbA1c≥6.0% in group C. The general information, BMI before delivery, neonatal weight, Apgar score, neonatal infection rate, cesarean section rate, and other adverse pregnancy outcomes were compared among the three groups. Results: There was no significant difference in age, parity, family history of diabetes, and history of adverse pregnancy of the women among the three groups (P＞0.05). The pre-delivery BMI value of the women in group B and group C was significantly higher than that of the women in group A (P＜0.001).There was a significant positive correlation between the average HbA1c level of the women during the third trimester of pregnancy and their pre-delivery BMI (r=0.647, P＜0.001). Meanwhile, the average HbA1c of the women during the third trimester of pregnancy had a weak positive correlation with their neonatal weight (r=0.2952, P＜0.001). The birth rate of macrosomia in group C (30.4%) was significantly higher than that (4.7%) in group A, and that (6.3%) in group B (P＜0.05). The 1min Apgar score of newborns in group B and C (8.1±0.9 and 8.0±1.0) was significantly lower than that (8.6±0.9 in group A (P＜0.05). The neonatal infection rate (20.3%) and the cesarean section rate (36.2%) in group C were significantly higher than those (7.8% and 20.3%) in group A, and those (12.5% and 21.9%) in group B (all P＜0.05). There were no significant differences in the rates of amniotic fluid contamination, premature delivery, intrauterine distress, and premature rupture of membranes among the three groups (P＞0.05). Conclusion: The level of HbA1c of the pregnant women with GDM during the third trimester of pregnancy is positively correlated with their BMI value before delivery and neonatal weight. When the pregnant women with GDM have poor blood glucose control (HbA1c≥6%), the birth rate of macrosomia and the cesarean section rate increase significantly.
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