Document Detail


Glycosylated hemoglobin level in the second trimester predicts birth weight and amniotic fluid volume in non-diabetic pregnancies with abnormal screening test.
MedLine Citation:
PMID:  20059437     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate relationship between glycemic control in first half of pregnancy by measuring mid-pregnancy HbA1c and neonatal birth weight and amniotic fluid volume.
METHODS: We prospectively enrolled 220 pregnant women who received oral glucose tolerance test (OGTT) after positive gestational diabetes mellitus screening. We included 102 women with normal OGTT results into final analysis. We measured birth weight and amniotic fluid index (AFI) at 32-34 weeks.
RESULTS: Mean birth weight was 3313±426 g, and 15.7% of neonates were classified as large-for-gestational age (LGA). Mean Hb1Ac was 4.96±0.28%. Median AFI was 145 mm, and polyhydramnios rate was 2.9%. Birth weight was positively correlated with HbA1c level (r=0.373, p<0.001) and pre-pregnancy body mass index (BMI; r=0.351, p<0.001). Linear regression analysis showed that HbA1c and pre-pregnancy BMI were positive independent determinants of neonatal birth weight, and HbA1c was positive independent determinant of AFI. Receiver operating characteristics curve identified HbA1c level of 4.99 as optimal threshold for prediction of LGA with 93.8% sensitivity, 61.6% specificity and positive likelihood ratio (+LR) of 2.45 and pre-pregnancy BMI value of 25.2 as optimal threshold for prediction of LGA with 81.3% sensitivity, 57% specificity and +LR of 1.9.
CONCLUSION: In non-diabetic pregnant women with abnormal screening test, mid-pregnancy HbA1c level and pre-pregnancy BMI may predict neonatal birth weight. AFI in 32-34 weeks of gestation is related with mid-pregnancy HbA1c level.
Authors:
Deniz Karcaaltincaba; Serdar Yalvac; Omer Kandemir; Serpil Altun
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  23     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-13     Completed Date:  2011-01-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  1193-9     Citation Subset:  IM    
Affiliation:
Etlik Zubeyde Hanim Women's Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey. denizaltincaba@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Amniotic Fluid
Blood Glucose
Body Mass Index
Female
Fetal Macrosomia*
Glucose Tolerance Test
Hemoglobin A, Glycosylated*
Humans
Middle Aged
Pregnancy
Pregnancy Trimester, Second
Prospective Studies
ROC Curve
Young Adult
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Hemoglobin A, Glycosylated; 0/hemoglobin A1c protein, human

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