Glycosylated hemoglobin values in nondiabetic pregnant women in the third trimester and adverse fetal outcomes: An observational study

Abstract

Objective: The objective of the study is to estimate the level of glycosylated hemoglobin (HbA1c) for a safe fetal outcome and to estimate the relation between this level and various adverse fetal outcomes. Materials and Methodology: Primigravidas who are diagnosed as not having gestational diabetes mellitus as per the glucose challenge test done at 24 weeks with a cutoff value up to 140 mg/dl are followed up at 30-34 weeks for the estimation of HbA1c in the blood and further till the time of delivery and postnatal period for the fetal outcomes. Data were collected based on detailed patient interview, clinical examination, and laboratory investigations. Data were analyzed to obtain the mean value of HbA1c in the third trimester. Fetal outcomes were analyzed with the HbA1c value using Chi-square test. Results: The HbA1c values in the third trimester of pregnancy in this study ranged from 4.5% to 6%. Discussion: Unfavorable outcomes were found the least in the 4.5%-5%. The average plasma blood glucose corresponding to HbA1c value of 5% is 101 mg/dl. The majority of the newborn were admitted for observation for transient tachypnea (49.5%) and hyperbilirubinemia (16.5%) requiring phototherapy, hypocalcemia requiring calcium supplements (12.6%), hypoglycemia requiring glucose (7.8%), and persistent tachypnea of newborn (5.8%) and all the outcomes correlated significantly with HbA1c values. Conclusion: Hence, HbA1c can be utilized for the monitoring of glycemic level and as screening test.

Keywords

• Fetal outcomes
• glycosylated hemoglobin
• nonpregnant diabetic women
• third trimester