Relationship between Glycosylated Haemoglobin Levels and Perinatal Outcome among Women with Gestational Diabetes Mellitus at the University of Port Harcourt Teaching Hospital, Nigeria

Abstract

Background: Gestational diabetes mellitus (GDM) is a global health challenge and is known to affect pregnancy adversely. Glycosylated haemoglobin (HbA1c) level reflect long term glycaemic control and is a more accurate measure than Fasting Plasma Glucose and post prandial plasma glucose level. Aims and Objectives: To determine the levels of HbA1c, perinatal outcomes and the relationship between maternal HbA1c level and perinatal outcomes in women with GDM at the University of Port Harcourt Teaching Hospital. Materials and Methods: This was a longitudinal study of 80 pregnant women from 36 weeks of gestation with GDM attending the antenatal clinic of the University of Port Harcourt Teaching Hospital (UPTH). Blood samples from all consenting pregnant women were collected and sent to the Chemical Pathology laboratory to determine the HbA1c level. The blood samples from the babies were also sent to determine the random plasma glucose (RPG) level. A structured proforma was used to obtain socio-demographic characteristics and other information. Data collected was analyzed with SPSS version 22.0. Results: The mean age of the women was 32.58 ± 4.95 years. A total of 57 (71.3%) women with GDM had elevated HbA1c levels (≥ 6.5%). Fetal macrosomia occurred in 17.5%, while 8.8% had birth asphyxia. The perinatal mortality ratio was 1.3%. There was a statistically significant relationship between HbA1c levels and neonatal hypoglycemia and perinatal mortality (p <0.05).                                                                                                                                      Conclusion: Despite the higher proportions of adverse perinatal outcomes occurring among those with elevated HbA1c levels, only neonatal hypoglycemia and perinatal mortality were significantly associated with elevated HbA1c.