Association between glycated albumin, fructosamine, and HbA1c with neonatal outcomes in a prospective cohort of women with gestational diabetes mellitus

Abstract

Objective: To investigate whether glycated albumin, fructosamine, and hemoglobin A1c (HbA1c) are associated with neonatal complications in newborns of pregnant women with gestational diabetes mellitus (GDM). Methods:Between November 2016 and September 2017, women with a singleton pregnancy and GDM were enrolled in a prospective study in an obstetric Portuguese referral center. Glycemic markers were compared between mothers of newborns with and without complications. Multivariable logistic regression models and corresponding areas under the receiver operating characteristic curve (AUC) were used.Results: A total of 85 women participated in the study. Raised levels of glycated albumin and fructosamine were associated with at least one neonatal complication (OR-[odds ratio] estimate: 1.33, P=0.015; OR: 1.24, P=0.027, respectively) and with respiratory disorders at birth (OR 1.41, P=0.004; OR 1.26, P=0.014, respectively). HbA1c was not associated with these outcomes. All biomarkers were associated with large-forgestational age (LGA) status (OR 1.61, P<0.001; OR 1.45, P<0.001; OR 3.62, P=0.032 for glycated albumin, fructosamine, and HbA1c, respectively). All had similar AUC for at least one neonatal complication (0.82; 0.81; 0.79, respectively). For newborn respiratory disorders, AUCs were 0.83, 0.81, and 0.76, respectively, and for LGA status were 0.81, 0.79, and 0.71, respectively. Conclusion:Raised values of glycated albumin and fructosamine were associated with particular perinatal complications in newborns of mothers with GDM, better discriminating mothers of newborns with and without complications than HbA1c. K E Y W O R D S

Association Between Maternal Glucose/Lipid Metabolism Parameters and Abnormal Newborn Birth Weight in Gestational Diabetes Complicated by Preeclampsia: A Retrospective Analysis of 248 Cases

“…Therefore, many researchers question its value as a suitable pregnancy biomarker [23]. However, it has also been reported that the high HbA1c of GDM pregnant women in late pregnancy is related to macrosomia [24]. The clinical analysis of GCP in this study shows that high HbA1c in late pregnancy is an independent risk factor for LGA, while high blood glucose in the same period is not associated with…”

Reference Interval of Hemoglobin A1c and Influence of Hematological Parameters on Its Serum Concentration in Dogs

“…In former times and in veterinary medicine, long-term hyperglycemia (1–3 weeks) is diagnosed by an elevated fructosamine concentration. Different human and veterinary studies show a significant correlation between HbA1c and fructosamine [ 11 , 18 , 20 – 22 ]. This was confirmed in our study.…”

A Review on Research Progress in the Application of Glycosylated Hemoglobin and Glycated Albumin in the Screening and Monitoring of Gestational Diabetes

“…Sugawara et al 54 consider that when HbA1C is not statistically different, the risk of infant complications increases if GA≥15.80. Mendes et al 55 consider that GA is correlated with the neonatal complications of GDM patients while there is no significant correlation between HbA1C and the neonatal complications of GDM patients.…”

“…Some scholars suggest that the elevation of HbA1C is associated with other maternal complications 18 , 30 , 45 , 47 , 56–58 (see Table 3 ). The ADA suggests that HbA1C<6 at mid-pregnancy is associated with the lowest risk of maternal complications.…”