Predictive Value of Peripheral Blood FIB and HbA1c in Late Pregnancy for Adverse Pregnancy Outcomes in Gestational Diabetes Mellitus

TIAN Jifang; CHEN Wang; XU Min; SHAO Qin

doi:10.3639/j.issn.2095-3097.2024.09.028

Abstract：Objective To evaluate the predictive value of peripheral blood fibrinogen(FIB)and glycated haemoglobin(HbA1c)in late pregnancy for adverse pregnancy outcomes in gestational diabetes mellitus(GDM).Methods 112 GDM women admitted to our hospital from January 2022 to December 2023 were included,and categorized into normal outcome group and poor outcome group according to different pregnancy outcomes.Clinical data,adverse maternal and fetal outcomes,FIB and HbA1c levels were recorded in all subjects.Logistics regression was applied to analyze the risk factors for adverse pregnancy outcomes in GDM,Spearman correlation method was used to testify the correlation of FIB and HbA1c levels with adverse preg-nancy outcomes in GDM,and receiver operating characteristic curve(ROC)was used to evaluate the impact of FIB and HbA1c in late pregnancy for adverse pregnancy outcomes.Results Adverse pregnancy outcomes occurred in 34 GDM patients,with an incidence of 30.36％.No statistical difference was reported in age,number of live births,number of pregnancies,mode of delivery,family history of diabetes mellitus,hemorrhage during delivery,and prenatal body mass index between two groups(P＞0.05),while poor outcome group detected higher FIB and HbA1c levels compared to normal outcome group(P＜0.05).FIB and HbA1c levels were positively correlated with adverse pregnancy outcomes in GDM patients(r=0.387,0.481,P＜0.05).Compared with the HbA1c＜5.5％group,the HbA1c≥5.5％group had a higher incidence of premature rupture of mem-branes(P＜0.05);the FIB≥4.2 g/L group had a higher incidence of premature infants than the FIB＜4.2 g/L group.higher(P＞0.05);compared with the FIB ≥ 4.2g/L+HbA1c＜5.5％group,the incidence of premature rup-ture of membranes was higher in the FIB ≥ 4.2g/L+H-bA1c ≥ 5.5％group(P＞0.05).FIB and HbA1c were risk factors for adverse pregnancy outcomes in GDM patients(OR=3.142,22.512,P＜0.05).A cutoff value of 4.82 g/L and 5.76％for FIB and HbA1c resulted in an area under the curve of 0.846(95％CI:0.747～0.944),which was larger than the separate test of FIB0.742[0.742(95％CI:0.637～0.848)]and HbA1c[0.802(95％CI:0.704～0.900)].Conclusion Peripheral blood FIB and HbA1c in late pregnancy are risk factors for adverse pregnancy outcomes in patients with GDM,and the combined testing has a high predictive value for adverse pregnancy outcomes in GDM.