Evaluation of the Combination of HbA۱C with Hematocrit for Early Screening of Gestational Diabetes Mellitus

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 A۱c (HbA۱c) alone and in combination with hematocrit for early detection of gestational diabetes mellitus. Materials & Methods: In this prospective cohort research, ۳۷۳ pregnant women who referred to prenatal clinics were included. Hematocrit and HbA۱c were determined at gestational age of ۱۲ to ۱۶ weeks and compared with the oral glucose tolerance test (OGTT) results at gestational age of ۲۴-۲۸ weeks. Results: The best cut-off hematocrit for determining pregnancy diabetes mellitus was ۳۷.۳. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were ۷۰.۱۵%, ۶۴.۱۲%, ۳۲.۷۱ %, and ۸۹.۵۱% respectively. In terms of HbA۱c, the best cut-off value to determine GDM in pregnant women was ۵, with a sensitivity of ۹۸.۵۱%, specificity rate of ۹۹.۰۲%, PPV of ۹۵.۰۷%, and NPV of ۹۹.۴۹%. In terms of diagnosing GDM, the area under the ROC curve (AUC) for HbA۱c was equal to ۰.۹۸۵ which was higher than the AUC for the combination of HbA۱c with HCT. Conclusion: Measuring HbA۱c can be useful as a screening test for GDM, which is an inexpensive and available test. The combined evaluation of HbA۱c and hematocrit did not improve the diagnostic value of HbA۱c in GDM screening compared to exclusive evaluation of HbA۱c.

کلیدواژه ها:

Gestational Diabetes Mellitus ، HbA۱c ، Hematocrit ، Pregnancy