The Influence of High Glycosylated Hemoglobin Levels on Obstetrical and Neonatal Results in Diabetic Pregnant Women

Abstract

Objective: Diabetes is the most common metabolic disorder during pregnancy. In this retrospective study, we aimed to evaluate the association between high HbA1c levels of pregnant women diagnosed gestational diabetes mellitus with perinatal outcomes.Material and Methods: Our study includes 93 pregnant women who were diagnosed with gestational diabetes after the 22nd week of pregnancy between 2010 and 2015. The group with gestational diabetes mellitus was divided into 2 sub-groups whose HbA1c level was 6.5% and over (37 cases) and below 6.5% (56 cases) and examined comparatively with 208 non-diabetic pregnant women were used as controls, and the neonatal intensive care admission data was also analyzed.Results: Statistically significant difference was not seen among groups in terms of age, the number of abortus and stillbirths, the mode of delivery, 1. min. APGAR score (p>0.05). There was a statistically difference in terms of gravida, parity and the number of living (p=0.005, p=0.003), the gravida and parity of the gestational diabetes mellitus group were lower compared to the control group (respectively p=0.004, p=0.005 and p=0.020, p=0.007 and p=0.038). When the distribution of the patients was examined in terms of pregnancy weeks, the ratio of those who are term in the gestational diabetes mellitus group, which is HbA1c ≥6.5%, compared to the control group and the ratio of those who are late preterm was statistically significantly higher (p<0.001 and p=0.008). It was found that the birth weight in the gestational diabetes mellitus group, which is HbA1c <6.5% was higher, and the frequency of macrosomia in both sub-groups was higher (p=0.023 and p=0.005). Neonatal intensive care needs in the gestational diabetes mellitus group, which is HbA1c ≥6.5%, was higher (p<0.001).Conclusion: This study is the first one in the field. A positive correlation was found between high HbA1c levels and hospitalization in neonatal intensive care unit.