Abstract：【Objective】To investigate the relationship between the serum glycosylated hemoglobin (HbA1c) level, fetal ultrasound parameters and pregnancy outcome in patients with diabetes in the third trimester of pregnancy. 【Methods】From March 2021 to March 2022, 80 pregnant women with diabetes in the third trimester in Baoji People's Hospital (the observation group) were selected, and 50 pregnant women with normal blood glucose who had regular prenatal examination in Baoji People's Hospital during the same period were selected as the control group.Two groups of blood glucose levels and fetal ultrasound parameters were compared, including resistance index (RI), pulsatility index (PI), and systolic to diastolic ratio (S/D) of the umbilical and middle cerebral arteries. The observation group was followed up until after delivery, and was divided into a poor group and a good group based on different neonatal outcomes. We compared the serum HbA1c and ultrasound parameters of different groups of parturients. We selected clinical indicators with statistically significant differences and constructed receiver operating characteristic (ROC) curves for the subjects. Logistic regression was used to analyze the risk factors leading to adverse outcomes in newborns.【Results】The observation group had significantly higher levels of HbA1c, fasting blood glucose (FPG), 2-hour postprandial blood glucose (2hPG), and umbilical artery S/D than the control group, while the middle cerebral artery S/D was lower than the control group (P<0.05); There was no statistically significant difference (P>0.05) between the two groups in terms of umbilical artery RI, umbilical artery PI, middle cerebral artery RI, and middle cerebral artery PI. The levels of HbA1c, FPG, 2hPG, body mass index, and umbilical artery S/D in the poor group were significantly higher than those in the good group, while the middle cerebral artery S/D was lower than those in the good group (P<0.05); There was no statistically significant difference (P>0.05) between the two groups in terms of umbilical artery PI, umbilical artery PI, middle cerebral artery RI, middle cerebral artery PI, age, and gestational age. The ROC curve analysis results show that body mass index HbA1c、FPG、2hPG、 Umbilical artery S/D and middle cerebral artery S/D can be used to evaluate the adverse pregnancy outcome of diabetes patients in the third trimester of pregnancy. The area under the curve is 0.875, 0.864, 0.901, 0.973, 0.873, 0.838, respectively. The logistic regression model analysis results show that body mass index>26.286 kg/m2 HbA1c＞6.421％,FPG＞6.261 mmol/L,2hPG＞8.651 mmol/L,Umbilical artery S/D>3.472 and middle cerebral artery S/D ≤ 3.496 were risk factors for adverse pregnancy outcomes in pregnant women with diabetes in the third trimester of pregnancy (P<0.05). 【Conclusion】Monitoring the serum HbA1c level, umbilical artery S/D and middle cerebral artery S/D parameters in patients with diabetes in the third trimester of pregnancy has certain clinical significance in judging the intrauterine condition of the fetus and predicting adverse pregnancy outcomes.
王格丽, 邢悦, 李大鹏. 孕晚期妊娠期糖尿病孕妇血清HbA1c水平及胎儿超声参数与妊娠结局的相关性[J]. 医学临床研究, 2024, 41(9): 1368-1371.
WANG Geli, XING Yue, LI Dapeng. Correlation between Serum HbA1c Level of Pregnant Women with Diabetes in the Third Trimester and Fetal Ultrasound Parameters and Pregnancy Outcome. JOURNAL OF CLINICAL RESEARCH, 2024, 41(9): 1368-1371.
2024, Vol. 41 
