SERUM GLYCOSYLATED PROTEINS (GP): PREDICTORS OF MATERNAL-FETAL HYPERGLYCEMIA AND FETAL B.WT.?

Abstract

The usefulness of serum GP in detection of subtle hyperglycemia was studied in 3 groups of mother/infant pairs: 20 normal/20 AGA(GrI): 20 normal/20 MACRO, > 4.0kg (GrIII) and 9 diabetic mothers/10 neonates (GrIII). Two diabetics were class A, 4 class B and 3 class C. Maternal serum HbA1c and GP and cord GP were measured at delivery. Maternal age, gravidity, parity and gest. age were similar. GrII mothers gained more wt(p<0.01) than GrI(mean±SD, 41±13 vs 28±7 lbs resp.) but not sig. diff. than GrIII mothers (33±12 Ibs). B.Wt. and B.Wt.ratios were greater (p<0.01) in GrII (4.4±.3kg; 1.39±.1 resp.) than in GrI (2.9±.3kg; 0.9±.08) or GrIII(3.3±.9kg; 1.08±.25) neonates. HbA1c and GP were: GP values were above the 95th %ile in 44% of moms and 80% of newborns in GrIII as compared to 5% in GrII or GrI patients (p<0.01). Maternal GP correlated sig. (p<0.001) with cord GP in GrI (r=.87) and GrII (r=.77) but not in GrIII pairs. B.Wt., B.Wt.ratio and plasma glucose at 1hr correlated poorly with HbA1c and maternal or cord GP; however, B.Wt. and B.Wt.ratio correlated sig. (p<0.01) with maternal wt. gain. In summary, 1) GP are more useful than HbA1c in detecting short term hyperglycemia in diabetic mothers and infants at delivery; 2) glucose intolerance in macrosomic newborns and their mothers may be too subtle for detection by serum GP; 3) B.Wt. can be sig. correlated with maternal wt. gain but not with serum GP. ** p < 0.001