Haemoglobin AIc predicts the perinatal outcome in insulin-dependent diabetic pregnancies.

Haemoglobin AIc (Hb AIc) was measured in 112 insulin-dependent diabetic pregnancies on an average 4.7 times. Hb AIc was high in early pregnancy in all three patients with severe fetal malformations. There were six pregnancies with a perinatal death. The maximum Hb AIc values were significantly higher in the second trimester (p less than 0.001) in these pregnancies than in the other diabetic pregnancies. When neonatal hypoglycaemia was present, the mean maternal Hb AIc was significantly higher in the second (p less than 0.005) and third (p less than 0.02) trimesters of pregnancy than in the group without neonatal hypoglycaemia. In the group with neonatal hyperbilirubinaemia the mean maternal Hb AIc was significantly higher in the third trimester (p less than 0.02) than in the group with no neonatal hyperbilirubinaemia. The results suggest that poor metabolic control of maternal diabetes during the second trimester is associated with a clearly increased risk of perinatal death and during the second and third trimesters with metabolic derangements in the neonatal period. The results also indicate that Hb AIc could be used to detect the pregnant diabetics at special risk.