A prospective study on first trimester hba1c as predictor of gestational diabetes mellitus
Author(s): Reshma Devi MR, Bindu P and Licia Chacko
Abstract: Throughout pregnancy, maternal adaptations occur in multiple systems, including cardiovascular, respiratory, and metabolism. Aim of these maternal adaptations is to maintain a healthy balance between the mother and fetus while ensuring proper fetal development. In the context of glucose metabolism, these adaptations occur to ensure adequate shunting of glucose to promote fetal development while maintaining adequate maternal nutrition. After taking informed written consent, antenatal women attending Antenatal clinic of Department of Obstetrics and Gynaeology during 8-14 weeks of gestation, fulfilling the inclusion criteria, were enrolled as study subjects. A standard performa was given to all patients meeting the inclusion criteria. Performa included demographics, obstetric history, past history, family history, auxology, 1sttrimester HBA1C values, 2nd trimester GTT results and USG, 3rd trimester GTT and USG results, baby details. HbA1c was done routinely with other 1st trimester routine investigations. An ROC curve was constructed for the study sample to estimate the cutoff of HbA1c to predict GDM, and from the ROC curve the optimum cut off for predicting GDM in this study population was obtained as 5.55% which has a sensitivity of 86%, specificity of 77%, PPV of 46.6% and NPV of 96%. The area under the ROC curve was found to be 0.85 which indicate HbA1c has good predictive value for GDM.
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