Usefulness of Glycated Albumin Levels in Predicting the Maternal or Neonatal Complications of Gestational Diabetes Mellitus during Late Pregnancy in South Korea: A Retrospective Study.

Abstract

Gestational diabetes can lead to complications in pregnant women and neonates. Maternal glycated albumin levels during late pregnancy may help predict complications in both mothers and neonates. This study was conducted in 120 singleton pregnant women diagnosed with gestational diabetes who visited Trinium Woman's Hostipal between July 1, 2020, and June 30, 2022. In this study, the patients' medical records were retrospectively analyzed. Gestational diabetes was diagnosed using a two-step testing method, and glycated albumin tests were performed during the third trimester of pregnancy. The optimal cutoff value of glycated albumin for predicting maternal complications during pregnancy and neonatal complications was determined using the receiver operating characteristic curve. A total of 45 patients developed maternal complications, with cesarean section (39 patients) due to fetal cephalopelvic disproportion being the most common. As for the neonatal complications, eight neonates were macrosomic or overweight, while 15 neonates required neonatal intensive care unit admission. Additionally, 13 patients had concurrent complications affecting both the mother and neonate. The glycated albumin level in patients with complications was 12.87%, which was significantly higher than that in patients without complications (glycated albumin, 11.67%) (P<0.001). The optimal cutoff value of glycated albumin for predicting maternal and neonatal complications was 12.45%. The sensitivity, specificity, and Youden index were 66.7 %, 86.7%, and 0.534, respectively. The third trimester glycated albumin test in mothers with gestational diabetes provides limited predictive value for maternal and neonatal complications.