Effect of Glycemic Control on Pregnancy out Come in Diabetic Pregnant Women at Obstetric and Gynecological Department in Tripoli-Libya

الملخص

Elevated HbA1c is associated with increased risk of adverse pregnancy outcomes including abortion, stillbirth, and
congenital abnormalities. The study conductedto assess the association between hemoglobin A1c (HbA1c) and the
risk of adverse pregnancy outcomes in diabetic pregnancies.
A cross sectional study included all pregnant diabetic women (251) in a Tripoli University Hospital from January
2017 to January 2018. HbA1c values from first, second and third trimester were collected, and pregnancy outcome
was categorized as good (babies surviving the first month of life without major congenital abnormalities) and
adverse (spontaneous and therapeutic abortion, stillbirth, neonatal death, or major congenital abnormalities detected
within the first month). The frequency of adverse outcomes was calculated according to HbA1c values.
This study identified 251 diabetic pregnant women in the study period. Twenty-seven women with type 1 diabetes
(10.4%), 123 gestational (47.3%) and 101with type 2 diabetes (38.8%) were included in the study. Mean HbA1c
early in pregnancy measured in a central laboratory, was higher in the women with an adverse outcome group
(P=0.009). Second and third trimester HbA1c and mean HbA1c during pregnancy were higher in the women with
an adverse outcome group (P = 0.002, P = 0.001 respectively).
Strong correlation between high HbA1c values and pregnancy adverse outcome specific to every trimester,
optimizing glycemic control during pregnancy will reduce these adverse effects.