HbA1c level in last trimester pregnancy in predicting macrosomia and hypoglycemia in neonate
DOI:
https://doi.org/10.18203/2349-3291.ijcp20163672Keywords:
HbA1c level, Hypoglycemia, Macrosomia, PregnancyAbstract
Background:The usefulness of single value of HbAlc during last trimester in pregnancies complicated by diabetes either pre-existing or gestational diabetes in predicting macrosomia and neonatal hypoglycemia is investigated. The aim of the study was to anticipate and manage the difficult labor due to macrosomia and to monitor these high risk newborns closely for hypoglycemia thereby preventing the neonatal morbidity.
Methods: A Prospective observational study of 96 mothers was done for a period of one year from June 2012 to September 2013 in a tertiary care centre. HbAlc level was estimated as one time blood test in the last trimester of pregnancy. At delivery anthropometric measurements of the baby were recorded and an intra-uterine growth chart was used to check whether the baby is macrosomic or not. Any difficult or non-progression of labor and ceaserian section details are recorded. Macrosomia is birth weight more than 90th percentile for the gestational age. Hypoglycemia occurs when blood sugar level found to be <40 mg/dl at 3 hours of life. Chi square test is used to see the correlation between HbAlC and macrosomia and hypoglycemia.
Results:20 babies had macrosomia and 22.9% of them had hypoglycemia. HbAlc <5.7 is defined as normal and HbAlc > 5.7% as abnormal. Mothers with abnormal HbAlc levels had a statistically significant correlation (P <0.001) to occurrence of Macrosomia and hypoglycemia in babies.
Conclusions:An abnormal HbAlc in third trimester in pregnancies complicated by diabetes can predict Macrosomia and hypoglycemia in the neonates.
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References
Mikkelsen MR, Nielsen SB, Stage E, Mathiesen ER, Damm P. High maternal HbA1c is associated with overweight in neonates. Dan Med Bull. 2011;58(9):4309.
Arumugam K, Majeed AN. Glycated haemoglobin is a good predictor of neonatal hypoglycaemia in pregnancies complicated by diabetes. Malays J Pathol. 2011;33(1):21-4.
Brenner WA, Green OC, Ferber A, Divon MY. Does the availability of maternal HbA1c results improve the accuracy of sonographic diagnosis of macrosomia? Ultrasound Obstet Gynecol. 2004;23(5):466-71.
Kline GA, Edwards A. Antepartum and intra-partum insulin management of type 1 and type 2 diabetic women: Impact on clinically significant neonatal hypoglycemia. Diabetes Res Clin Pract. 2007;77(2):223-30.
Taylor R, Lee C, Grzebalski KD, Marshall SM, Davison JM. Clinical outcomes of pregnancy in women with type 1 diabetes. Obstet Gynecol. 2002;99(4):537-41.
Rackham O, Paize F, Weindling AM. Cause of death in infants of women with pregestational diabetes mellitus and the relationship with glycemic control. Postgrad Med. 2009;121(4):26-32.
Nielsen LR, Ekbom P, Damm P, Glumer C, Frandsen MM, Jensen DM, Mathiesen ER. HbA1c levels are significantly lower in early and late pregnancy. Diab Care. 2004;27(5):1200-1.
Evers IM, Valk HW, Mol BW, Braak EW, Visser GH. Macrosomia despite good glycaemic control in Type I diabetic pregnancy; results of a nationwide study in the Netherlands. Diabetologia. 2002;45(11):1484-9.
NNF Clinical Practice guidelines, Evidence Based clinical Guidelines, Neonatology forum, India. Oct 2010:63.
The hapo study cooperative research group hyperglycemia and adverse pregnancy outcomes. New Engl J Med. 2008;358:1991-2001.
Olsen IE, Groveman SA, Lawson MA, Clark RH, Zemel BS. New intrauterine growth curves based on United States data. Pediatrics. 2010;125:2.
Paul VK, Jain A, Aggarwal R, Jeevasankar M, Deorari AK. Hypoglycaemia in the newborn. Indian J Paediatr. 2008;75(1):63-7.
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