Background: Gestational diabetes mellitus (GDM) and adverse pregnancy outcomes are correlated. The oral glucose tolerance test (OGTT) is the gold standard method for screening GDM. Glycated hemoglobin (HbA1c) levels are a useful screening test for detecting GDM. The use of HbA1c in screening for GDM has been demonstrated by several studies.
Objectives: To find the usefulness of HbA1c levels in diagnosing gestational diabetes mellitus and its association with adverse maternal and neonatal effects.
Materials and methods: This prospective cohort study was conducted at Christian Medical Hospital, Ludhiana. About 500 antenatal women attending the outpatient department were subjected to 75 gm OGTT, and HbA1c and GDM being diagnosed using DIPSI criteria. The perinatal outcomes were compared in women with and without GDM.
Results: Among the 500 antenatal patients evaluated, 23 were lost to follow-up and excluded from the study. The incidence of GDM was 16.8% (n = 80). Women with GDM and without GDM had a mean HbA1c level of 5.55 ± 0.74% and 4.95% ± 0.74%, respectively. The optimal HbA1c cut-off for diagnosing GDM was 5.15% with sensitivity of 74% and specificity of 69.8%.
Conclusions: HbA1c with a cutoff of 5.15% can be used as a screening test and avoid the need of OGTT in approximately 50% of antenatal women.
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