LAUSR

AIM To assess the efficacy of first trimester glycated hemoglobin (HbA1c-FT) to in diagnosinge or predicting gestational diabetes mellitus (GDM) in Asian Indian women. METHODS This retrospective cohort study involved 2275 women who underwent both HbA1c -FT estimation and GDM screening by with aone-step 75 g oral glucose tolerance test. Receiver oOperating cCharacteristic (ROC) curve wasstatistics were applied to assess the discriminativeng ability of HbA1c-FTfor inGDM diagnosis. A multivariable logistic regression analysis after adjustment adjustingfor plausible confounders was used to evaluated the independent effect of HbA1c-FT on GDM diagnosis. RESULTS The mMean HbA1c-FT of GDM (n=578) and non-GDM women (n=1697) were 5.04+0.04% and 4.9+0.37%, respectively (p<0.001). Compared to women with a HbA1c-FT <5.2%, the adjusted odds ratioto develop GDM of women with an HbA1c-FT range of 5.2 to 5.5 % and those >5.6 % to develop GDM were 1.627 (p <.004) and 2.6 (p <0.001), respectively. The area under the ROC curve to detect GDM was 0.606 (95% CI:0.519 to 0.633 p <0.001), but the sensitivity and specificity of the HbA1c-FT were not sufficient to diagnose, rule in or rule out GDM. CONCLUSIONS HbA1c-FT is an independent GDM predictor in Asian Indian women but lacks sufficient sensitivity or specificity for use as a diagnostic test.