Role of First Trimester Glycosylated Hemoglobin in Early Detection of Gestational Diabetes Mellitus: An Observational Study
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Abstract
Background: Gestational diabetes mellitus (GDM) is a common metabolic disorder in pregnancy associated with adverse maternal and neonatal outcomes. Early identification of high-risk women remains a clinical challenge, and first trimester HbA1c has emerged as a potential screening tool. The study was conducted to evaluate the prevalence of GDM and assess the predictive value of first trimester HbA1c for the development of GDM.
Methods: This prospective observational study included 140 pregnant women enrolled in the first trimester at a tertiary care centre. HbA1c levels were measured during early pregnancy. Participants were screened for GDM at 24 and 28 weeks of gestation using standard diagnostic criteria. Associations between first trimester HbA1c levels and subsequent GDM diagnosis were analysed.
Results: The overall prevalence of GDM was 26.4%. Most cases were diagnosed at 24 weeks, with only a small proportion identified at 28 weeks. Mean first trimester HbA1c levels were significantly higher in women who developed GDM compared to those who remained normoglycemic (p = 0.002). A significant association was observed between HbA1c categories and GDM diagnosis (p < 0.001), with all women in the high HbA1c group developing GDM, while the majority with normal HbA1c remained normoglycemic.
Conclusion: First trimester HbA1c is a strong predictor of GDM and can serve as a practical early screening tool. Incorporating HbA1c into routine antenatal care may facilitate early risk stratification, timely intervention, and improved pregnancy outcomes, particularly in high-risk populations.
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