The relationship between glycosylated hemoglobin A1c (HbA1c) levels and pregnancy complications in a diabetic pregnant women-Retrospective case-control study

Öz

Aim: To determine whether there is a relationship between glycosylated hemoglobin A1C (HbA1c) levels and complications that may occur during pregnancy in pregnant women with diabetes mellitus (DM). Material-Methods: Our study is a retrospective case-control study. It was carried out in Aydın Adnan Menderes University hospital between January 2013 and December 2017. It was performed on 321 patients. Results: HbA1c values were pregnant women's 4-5.9% in 66 , 6-7.9% in 157 HbA1c≥8% in 91. Compared to gestational diabetes mellitus (GDM), preeclampsia, fetal distress, preterm delivery, shoulder dystocia, and neonatal hypoglycemia were found more frequently in pregnant women with pregestational DM (p<0.05). Compared to type 2 DM, threatened premature birth (TPL), polyhydramnios, hyperbilirubinemia, neonatal hypoglycemia, and neonatal weight loss were found more frequently in pregnant women with type 1 DM (p<0.05). Compared to normal HbA1c values in pregnant women, GHT, preeclampsia, TPL, oligohydramnios, polyhydramnios, LGA, fetal distress, preterm birth, neonatal hypoglycemia, neonatal weight loss, neonatal respiratory distress, respiratory distress syndrome (RDS), hyperbilirubinemia and ex fetus were found more frequently in pregnant women with HbA1c≥8% and HbA1c beetwen 6-7.9% (p<0.05). In pregnants with GDM diagnosis with HbA1c>6% and HbA1c between 5-5.9%, GHT, preeclampsia, TPL, polyhydramnios, small for gestational age (SGA), LGA, fetal distress, preterm birth, neonatal hypoglycemia, and neonatal respiratory distress were found more frequently compared to pregnants with 4-4.9% HbA1c. Conclusion: Obstetric complication rates increased in pregnant women with pregestational DM, Type 1 DM, GDMA2 and high HbA1c values.

Anahtar Kelimeler

• Glycolyzed Hemoglobin A1c (HbA1c)
• Pregnancy Complication
• Gestational Diabetes Mellitus
• Pregnancy in Diabetes

Diyabetik gebelerde glikolize hemoglobin A1c (HbA1c) düzeyi ile gebelik komplikasyonları arasındaki ilişki-Retrospektif vaka-kontrol çalışması

Öz

Amaç: Diabetes mellitus (DM) tanılı gebelerde glikolize hemoglobin A1C (HbA1c) düzeyleri ile gebelikte meydana gelebilecek olan komplikasyonlar arasında ilişki olup olmadığını saptamak. Gereç ve Yöntemler: Çalışmamız retrospektif vaka-kontrol çalışmasıdır. Ocak 2013 ve Aralık 2017 tarihleri arasında Aydın Adnan Menderes Üniversitesi hastanesinde yapılmıştır. Çalışmamız 321 hasta üzerinde yapılmıştır. Hastalarda HbA1C düzeyine göre komplikasyon oranlarına bakılmıştır. Bulgular: HbA1c değerleri 66 gebede %4-5.9, 157 gebede %6-7.9 ve 91 gebede HbA1c≥%8’dir. Pregestasyonel DM tanılı gebelerde gestasyonel diabetes mellitus (GDM) tanılı gebelere kıyasla preeklampsi, fetal distres, preterm doğum, omuz distosisi ve yenidoğan hipoglisemisi daha sık saptanmıştır (p<0.05). Tip 1 DM tanılı gebelerde Tip 2 DM tanılı gebelere kıyasla erken doğum tehdidi (EDT), polihidroamnios, hiperbilirübinemi, yenidoğan hipoglisemisi ve yenidoğan kilo kaybı daha sık saptanmıştır (p<0.05). GDMA2 tanılı gebelerde GDMA1 tanılı gebelere kıyasla gestasyonel hipertansiyon (GHT), preeklampsi, EDT ve large for gestational age (LGA) daha sık saptanmıştır (p<0.05). GDMA1 tanılı gebelerde oligohidroamnios daha sık saptanmıştır (p<0.05). HbA1c≥%8 ve HbA1c %6-7.9 olan gebelerde HbA1c değeri normal olan gebelere kıyasla GHT, preeklampsi, EDT, oligohidroamnios, polihidroamnios, LGA, fetal distres, preterm doğum, yenidoğan hipoglisemisi, yenidoğan kilo kaybı, yenidoğan solunum sıkıntısı, respiratuar distres sendromu (RDS), hiperbilirübinemi ve intrauterin ex fetüs daha sık saptanmıştır (p<0.05). GDM tanılı HbA1c>%6 ve HbA1c %5-5.9 olan gebelerde HbA1c %4-4.9 arasında olan gebelere kıyasla GHT, preeklampsi, EDT, polihidroamnios, small for gestational age (SGA), LGA, fetal distres, preterm doğum, yenidoğan hipoglisemisi ve yenidoğan solunum sıkıntısı daha sık saptanmıştır (p<0.05). Sonuç: Pregestasyonel DM, Tip 1 DM, GDMA2 ve yüksek HbA1c değeri olan gebelerde obstetrik komplikasyon oranlarında artma olduğu saptanmıştır.

Anahtar Kelimeler

• Glikolize hemoglobin A1c (HbA1c)
• Gebelik Komplikasyonu
• Gestasyonel Diabetes Mellitus
• Diyabette Gebelik

Kaynakça

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