The Role of Early Pregnancy Maternal pGCD59 Levels in Predicting Neonatal Hypoglycemia—Subanalysis of the DALI Study

Abstract

OBJECTIVE The aim of this study was to assess the association between early pregnancy maternal levels of plasma glycated CD59 (pGCD59) and neonatal hypoglycaemia (NH). MATERIALS and METHODS This is an observational study of pregnant women with a pre-pregnancy body mass index (BMI) ≥ 29 kg/m2 screened for eligibility to participate in the Vitamin D and Lifestyle Intervention for Gestational Diabetes (DALI) trial. This analysis included 399 pregnancies. Levels of pGCD59, were measured in fasting maternal samples taken at the time of a 75 g, 2-hour oral glucose tolerance test (OGTT) performed in early pregnancy (<20 weeks). NH, the study outcome, was defined as a heel-prick capillary glucose level of less than 2.6 mmol/L within 48 h of delivery. RESULTS We identified 30 infants with NH. Maternal levels of pGCD59 in early pregnancy, were positively associated with the prevalence of NH (ANOVA one-way, p-value <0.001). The odds of NH were higher in infants from mothers in the Tertile 3 of pGCD59 levels as compared to those from mothers in Tertile 1 (OR: 2.41, 95% CI: 1.03–5.63). However, this was attenuated when adjusted for maternal BMI (OR: 2.28 (95% CI: 0.96–5.43). The cross-validated area under the curve (AUC) was 0.64 (95% CI: 0.54–0.74), and adjusted for maternal BMI, age, and ethnicity, the AUC was 0.70 (95% CI: 0.56–0.78). CONCLUSION Although pGCD59 levels in early pregnancy in women with BMI ≥29 kg/m2 are associated with NH, our results indicate that this biomarker by itself is only a fair predictor of NH.