Hba1c as a predictor of fetal outcomes in pregestational diabetes mellitus

The increasing number of people with diabetes melitus (DM) will increase the possibility of the number of pregnancies with pregestational DM. In pregestational DM, HbA1c examination is required, which tends to be more expensive to predict the possibility of complications and prognosis. The purpose of this study was to determine the examination of fasting blood glucose and 2-hours postprandial glucose (PPG) compare to HbA1c as predictor of fetal outcome. Data were collected from pregestational DM patients at Dr. Soetomo Hospital, Surabaya, through medical records. Data were in the form of HbA1c, fasting blood glucose and 2-hour PPG values for preterm fetal outcomes. In the first trimester, we only obtained one patient with normal HbA1c (<6.5%), normal PPG (<90 mg/dl), but 2-hour PPG was above normal (> 120 mg/dl). Of the 42 cases of Pregestational DM, a 5% HbA1c value had sensitivity (91.67%) and specificity (33.33%) on the results of fasting blood glucose and PPG, where fasting blood glucose values with sensitivity and specificity were best for predicting preterm fetal outcomes, with an accuracy of 76.67%, while 2-hour PPG with an accuracy of 83.33%. The fasting blood glucose value with good sensitivity and specificity to predict preterm fetal outcomes was 74 mg/dl with an accuracy of 76.67% whereas 2hour PPG is worth 99 mg/dl with an accuracy of 83.33%.At this time, HbA1c is still a predictor of fetal outcomes (preterm) in Pregestational DM patients better than fasting blood glucose and 2-hour PPG.