Write your message
Volume 6, Issue 4 (Fall 2021)                   J Obstet Gynecol Cancer Res 2021, 6(4): 217-223 | Back to browse issues page


XML Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Norouzi A R, Siavashi M, Norouzi F, Talayeh M, Noei Teymoordash S. Evaluation of the Combination of HbA1C with Hematocrit for Early Screening of Gestational Diabetes Mellitus. J Obstet Gynecol Cancer Res. 2021; 6 (4) :217-223
URL: http://jogcr.com/article-1-379-en.html
1- Pediatric Respiratory Diseases Research Center (PRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2- Department of Obstetrics and Gynecology, Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), Iran University of Medical Sciences, Tehran, Iran
3- Department of Midwifery, Tehran University of Medical Sciences, Tehran, Iran
4- Department of Gynecology Oncology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5- Department of Obstetrics and Gynecology, Iran University of Medical Sciences, Tehran, Iran , noeiteymoordash.s@sbmu.ac.ir
Abstract:   (197 Views)

Background & Objective: Gestational diabetes mellitus (GDM) is the most prevalent disorder during pregnancy, which is the result of insulin resistance and hyperinsulinemia due to the secretion of placental diabetogenic hormones. This study aimed to investigate the utility of glycated hemoglobin A1c (HbA1c) alone and in combination with hematocrit for early detection of gestational diabetes mellitus.
Materials & Methods: In this prospective cohort research, 373 pregnant women who referred to prenatal clinics were included. Hematocrit and HbA1c were determined at gestational age of 12 to 16 weeks and compared with the oral glucose tolerance test (OGTT) results at gestational age of 24-28 weeks.
Results: The best cut-off hematocrit for determining pregnancy diabetes mellitus was 37.3. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 70.15%, 64.12%, 32.71 %, and 89.51% respectively.
In terms of HbA1c, the best cut-off value to determine GDM in pregnant women was 5, with a sensitivity of 98.51%, specificity rate of 99.02%, PPV of 95.07%, and NPV of 99.49%. In terms of diagnosing GDM, the area under the ROC curve (AUC) for HbA1c was equal to 0.985 which was higher than the AUC for the combination of HbA1c with HCT.
Conclusion: Measuring HbA1c can be useful as a screening test for GDM, which is an inexpensive and available test. The combined evaluation of HbA1c and hematocrit did not improve the diagnostic value of HbA1c in GDM screening compared to exclusive evaluation of HbA1c.

Full-Text [PDF 568 kb]   (44 Downloads) |   |   Full-Text (HTML)  (13 Views)  
Systematic Review: Original Research | Subject: Maternal Fetal Medicine
Received: 2021/02/25 | Accepted: 2021/05/4 | Published: 2021/08/11

References
1. Hughes RC, Rowan J, Florkowski CM. Is there a role for HbA1c in pregnancy? Curr Diabetes Rep. 2016;16(1):5. [DOI:10.1007/s11892-015-0698-y] [PMID]
2. Gelaye B, Clish C, Denis M, Larrabure G, Tadesse M, Deik A, et al. Metabolomics signatures associated with an oral glucose challenge in pregnant women. Diabetes Metabol. 2019;45(1):39-46. [DOI:10.1016/j.diabet.2018.01.004] [PMID] [PMCID]
3. Wu BJ, Sun Y, Ong K-L, Li Y, Tang S, Barter PJ, et al. Apolipoprotein AI Protects Against Pregnancy-Induced Insulin Resistance in Rats. Arterioscler Thromb Vasc Biol. 2019;39(6):1160-71. [DOI:10.1161/ATVBAHA.118.312282] [PMID]
4. Nikolic D, Al-Rasadi K, Al Busaidi N, Al-Waili K, Banerjee Y, Al-Hashmi K, et al. Incretins, pregnancy, and gestational diabetes. Curr Pharm Biotechnol. 2016;17(7):597-602. [DOI:10.2174/1389201017666160127110125] [PMID]
5. Faroughi F, Mohammad-Alizadeh Charandabi S, Javadzadeh Y, Mirghafourvand M. Effects of Garlic Pill on Blood Glucose Level in Borderline Gestational Diabetes Mellitus: A Triple Blind, Randomized Clinical Trial. Iran Red Crescent Med J. 2018;20(7):e60675. [DOI:10.5812/ircmj.60675]
6. Metzger BE, Coustan DR, Trimble ER. Hyperglycemia and adverse pregnancy outcomes. Clin Chem. 2019;65(7):937-8. [DOI:10.1373/clinchem.2019.303990] [PMID]
7. Sheikhi H, Jahromi MZ, Sheikhi A, Mastalizadeh H. The effect of physical activity training through focused group discussions on fasting blood glucose level on pregnant women with gestational diabetes. Revista QUID. 2017;1(1):2830-4.
8. Richard JLC, Eichhorn PJA. Deciphering the roles of lncRNAs in breast development and.
9. Women's NCCf, Health Cs. Diabetes in pregnancy: management of diabetes and its complications from preconception to the postnatal period. 2015.
10. Belton A, Mohen V, Mahalakshmi S, Ranjit U, Anjana R, Ram D. Management of gestational diabetes in the community, training manual for community. Kenya: Training Manual for Community Health Workers. 2015:6-8.
11. Katon J, Williams MA, Reiber G, Miller E. Antepartum A1C, maternal diabetes outcomes, and selected offspring outcomes: an epidemiological review. Paediatr Perinat Epidemiol. 2011;25(3):265-76. [DOI:10.1111/j.1365-3016.2011.01195.x] [PMID] [PMCID]
12. Wu K, Cheng Y, Li T, Ma Z, Liu J, Zhang Q, et al. The utility of HbA1c combined with haematocrit for early screening of gestational diabetes mellitus. Diabetol Metabol Synd. 2018;10. [DOI:10.1186/s13098-018-0314-9] [PMID] [PMCID]
13. Abbasi Fashami M, Hajian S, Afrakhteh M, Khabaz Khoob M. Relationship between level of red blood cell indices and risk of gestational diabetes mellitus: a case-control study. Iran J Obstet Gynecol Infertil. 2019;22(4):36-43.
14. Ryu AJ, Moon HJ, Na JO, Kim YJ, Kim SJ, Mo SI, et al. The Usefulness of the Glycosylated Hemoglobin Level for the Diagnosis of Gestational Diabetes Mellitus in the Korean Population. Diabetes Metabol J. 2015;39(6):507-11. [DOI:10.4093/dmj.2015.39.6.507] [PMID] [PMCID]
15. Damsgaard L, Pedersen ML. Use of glycosylated haemoglobin as diagnostic tool in Greenland: prevalence of diagnosed diabetes mellitus. Diabetol Metabol Synd. 2013;5(1):59. [DOI:10.1186/1758-5996-5-59] [PMID] [PMCID]
16. Ye M, Liu Y, Cao X, Yao F, Liu B, Li Y, et al. The utility of HbA1c for screening gestational diabetes mellitus and its relationship with adverse pregnancy outcomes. Diabetes Res Clin Pract. 2016;114:43-9. [DOI:10.1016/j.diabres.2016.02.007] [PMID]
17. Arbib N, Shmueli A, Salman L, Krispin E, Toledano Y, Hadar E. First trimester glycosylated hemoglobin as a predictor of gestational diabetes mellitus. Int J Gynecol Obstet. 2019; 145(2):158-63. [DOI:10.1002/ijgo.12794] [PMID]

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License Journal of Obstetrics, Gynecology and Cancer Research by Farname Inc is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. Based on a work at http://jogcr.com/.

© 2021 CC BY-NC 4.0 | Journal of Obstetrics, Gynecology and Cancer Research (JOGCR)

Designed & Developed by : Yektaweb | Piblisher: Farname Inc.