Association between Glycemic Control and Birth Weight with Glycated Albumin in Women with Gestational Diabetes Mellitus

Abstract

Background: Gestational diabetes mellitus (GDM) is defined as glucose intolerance that is primarily detected during pregnancy. Objective: To determine the relationship between glycemic control and glycated albumin in women with GDM. Patients and Methods: This prospective study was carried out in the Department of Obstetrics and Gynecology, Zagazig University Hospitals, Zagazig, Sharkia, Egypt from December 2018 to October 2019. The study included 30 patients suffering from GDM (study group) as well as another matching 30 women (control group). Maternal screening for all cases at 24-28 wks using a 75-gm oral glucose tolerance test (OGTT) which is a fasting blood glucose sample was done. Results: GA levels were significantly higher after 24 weeks of gestation in the GDM group compared with controls. Elevated GA levels had a positive correlation with birth weight. In the present study, fetal weight was significantly higher among the study group (3850.0±513.7) than controls (3396.6±334) (p < 0.001). Glycated albumin, HbA1c only showed association with large‐ for‐ date status. Also, GA24_28, more than 13.4 had a sensitivity of 82% and specificity of 72% for GDM. ROC curve, as the cut‐ off point for identifying poor glycemic control in GDM women, and provided the optimal sensitivity (75.93%) and specificity (86.36%). Conclusion: GDM women, the risk of macrosomia significantly increases when the GA levels are ≥14.45% in the third trimester. The results provide strong support for the use of GA measurements, as a complement to finger stick glucose, for assessing short‐ term glycemic control and predicting large birth weight in the GDM women.