Use of HbA1c as an Early Predictor of Gestational Diabetes Mellitus
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Abstract
Background: Gestational diabetes mellitus (GDM) is a growing global health concern, with increasing prevalence linked to rising obesity rates. Early identification of at-risk women can mitigate adverse maternal and fetal outcomes. Objectives: To evaluate whether a first-trimester HbA1c value of 5.7-6.4% serves as an early predictor of GDM in South Indian women. Methods: A prospective cohort study was conducted at XXXXXX, from January 2022 to January 2023. We included 150 antenatal women with HbA1c measured at ≤20 weeks gestation, excluding those with pre-existing diabetes or HbA1c ≥6.5%. GDM was diagnosed using a 2-hour 75g oral glucose tolerance test (OGTT) at 24-28 weeks per IADPSG criteria. Women with HbA1c 5.7-6.4% were compared to those with HbA1c <5.7%. Statistical analysis used unpaired t-tests, ANOVA, Chi-square, and Fisher’s exact tests. Results: Of 150 women, 130 (87%) had HbA1c <5.7%, and 20 (13%) had HbA1c 5.7-6.4%. GDM prevalence was 12%, with 55% of the HbA1c 5.7-6.4% group developing GDM compared to 5% in the HbA1c <5.7% group (OR 21.48, 95% CI 6.70-68.82, p<0.001). Overweight women predominated in the higher HbA1c group. Conclusion: First-trimester HbA1c (5.7-6.4%) is a significant early predictor of GDM, particularly in overweight South Indian women, supporting its use for early screening and intervention. Limitations include the small sample size in the higher HbA1c subgroup (n=20), precluding multivariable adjustments.
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Copyright (c) 2026 Dr. Aswini P, Dr. Vijayalakshmi Nambulla, Dr. Preetha Solomon
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