Correlation of glycosylated hemoglobin and macrosomia in infants of diabetic mothers

Abstract

Objective: Maternal diabetes mellitus has a significant impact on the neonatal outcome. Birth weight is related to the degree of glycemic control. Poor glycemic control in the mother causes somatic overgrowth and results in macrosomia. Maternal obesity is an independent risk factor for macrosomia. The study objective was to evaluate the correlation between glycosylated hemoglobin (HbA1c) level in diabetic mothers and macrosomia in their neonates. Methods: A cross-sectional observational study was done on diabetic mothers and their neonates. Maternal body mass index, weight gain, duration of diabetes and type of treatment were recorded. Maternal HbA1c levels were measured within one hour of delivery and birth order, mode of delivery, gestational age and birth weight were recorded. The discrete variables were analyzed by chi-square test and continuous variables by independent t-test. Receiver operating characteristic (ROC) analysis was used to determine the optimum cut-off for predicting macrosomia with HbA1c. A p-value of <0.05 was considered significant. Results: A total of 228 diabetic mothers and their neonates were studied and 18 neonates were macrosomic. Diabetes was pregestational in 56.6% of mothers and gestational in 43.4% of mothers. There was a significant difference in BMI, weight gain, and HbA1c in mothers of macrosomic and non-macrosomic neonates. There was no significant difference in mean values of maternal age, duration of diabetes and gestational age in the two groups. Conclusion: This study suggests that diabetic women with elevated HbA1c>5.6% measured after delivery were likely to have macrosomic neonates.