Glycosylated Haemoglobin (HbA1c) as a Diagnostic Criterion for Hyperglycaemia First Detected in Pregnancy

(HbA1c) as a Diagnostic Criterion for Hyperglycaemia First Detected in Pregnancy

Authors

  • Merry Alali Jaja Department of Obstetrics and Gynaecology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria
  • Abbey Mkpe Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria
  • Simeon Chijioke Amadi Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria
  • Tehemen Kasso Department of Obstetrics and Gynaecology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria
  • Frederick Allison Department of Chemical Pathology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
  • Olufemi Adebari Oloyede Department of Obstetrics and Gynaecology, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria
  • Esther Nonye-Enyidah Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria
  • Kenneth Okagua Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria
  • Ngozi Joseph Kwosah Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria
  • Paul Kua Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria
  • Rose Sitonma Iwo-Amah Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria
  • Alpheaus Gogo Mba Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria
  • Uduak S Ocheche PAMO University of Medical Sciences, Port Harcourt, Rivers State, Nigeria.
  • Basil Omieibi Altraide Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria
  • Leesi Sapira-Ordu Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria
  • Dickson Hezekiah John Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria
  • Ada Nkemagu Okocha Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria
  • Nestor Inimgba PAMO University of Medical Sciences, Port Harcourt, Rivers State, Nigeria
  • Christian Ihenachor Akani Department of Obstetrics and Gynaecology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria

Keywords:

Glycosylated Haemoglobin, Diagnostic Criterion, Hyperglycaemia; Pregnancy

Abstract

Background: The study was prompted by the high prevalence of hyperglycaemia first detected in pregnancy (HIP) which is classified into diabetes mellitus in pregnancy (DIP) and gestational diabetes mellitus (GDM). This study aimed to determine the usefulness of Glycosylated Haemoglobin (HBA1c) in the diagnosis of HIP in the first trimester of pregnancy.
Methodology: The study was of a prospective cross-sectional design carried out between January 2020 and August 2020 at the University of Port Harcourt Teaching (UPTH) and Rivers State University Teaching Hospital (RSUTH). Three hundred and five consecutive pregnant women attending the antenatal clinic at 8 to 13 +6 weeks of pregnancy were recruited for the study. Patients’ socio-demographic information, anthropometric measurements, and medical, obstetric, and gynaecological history were recorded on a predesigned proforma. Blood was taken for an oral glucose tolerance test (OGTT) and glycosylated haemoglobin (HBA1c) levels. Ethical approval for the study was obtained from the Research Ethics Committee of the UPTH and RSUTH. Results: The prevalence of DIP, GDM, and HIP in the study was 2.62%, 28.85%, and 31.48% respectively. The ROC curve for HbA1c in the study showed a significant area under the Curve (AUC) value of 0.653%, 95% CI = 0.59 – 0.72, p = 0.001. The Youden index reached 2.50 and the optimal cut-off for HBA1c for diagnosis of diabetes was 5.25%. The sensitivity, specificity, PPV, and NPV for HbA1c against the Gold standard OGTT in the diagnosis of GDM were 36.5%, 88.5%, 59.3, %, and 75.2% respectively. HbA1c had high specificity and moderately high NPV.
Conclusion: Glycosylated haemoglobin was a fairly good tool for diagnosis of HIP in the first trimester, but it could not replace OGTT which is the gold standard.

Published

11-05-2023

How to Cite

Jaja, M. A., Mkpe, A., Amadi, S. C., Kasso, T., Allison, F., Oloyede, O. A., Nonye-Enyidah, E., Okagua, K., Kwosah, N. J., Kua, P., Iwo-Amah, R. S., Mba, A. G., Ocheche, U. S., Altraide, B. O., Sapira-Ordu, L., John, D. H., Okocha, A. N., Inimgba, N., & Akani, C. I. (2023). Glycosylated Haemoglobin (HbA1c) as a Diagnostic Criterion for Hyperglycaemia First Detected in Pregnancy: (HbA1c) as a Diagnostic Criterion for Hyperglycaemia First Detected in Pregnancy. Nigerian Medical Journal, 64(2), 281–292. Retrieved from https://nigerianmedjournal.org/index.php/nmj/article/view/190

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