Abstract:

Objective To investigate the correlation of neonate birth weight with glycated hemoglobin A_1c（HbA_1c） and glycated albumin （GA） levels in patients with gestational diabetes mellitus（GDM）during the 3rd trimester pregnancy. Methods Totally,322 pregnant women registered for prenatal examination and delivery were enrolled. Their HbA_1c and GA levels were determined during the 3rd trimester pregnancy. They were classified into healthy control group（80 cases） and GDM group （242 cases,including 25 cases of macrosomia and 217 cases of non-macrosomia）. High-performance liquid chromatography was used to determine HbA_1c,and enzymatic method was used to determine GA. Pearson analysis was used to analyze the correlation of neonate birth weight with HbA_1c and GA,and receiver operating characteristic（ROC）curve was used to determine the optimal cut-off value of HbA_1c for the prediction of macrosomia. Results HbA_1c and GA levels in GDM group were higher than those in healthy control group（P<0.05）. HbA_1c level in GDM group and neonate birth weight were in positive correlation （r=0.212,P=0.001）,while there was no correlation with GA level （r=0.038,P=0.555）. According to HbA_1c level in GDM group,GDM group were subclassified into high HbA_1c group （132 cases,HbA_1c>5.29%） and low HbA_1c group （110 cases,HbA_1c≤5.29%）．The rate of macrosomia in high HbA_1c group （14.39%） was higher than that in low HbA_1c group（5.45%,P<0.05）. The optimal cut-off value of HbA_1c for the prediction of macrosomia was 5.25%,the sensitivity was 76.0%,the specificity was 47.9%,and the area under ROC curve was 0.642. Conclusions HbA_1c level is correlated with neonate birth weight in GDM group. Higher HbA_1c level is,higher the rate of macrosomia is. HbA_1c levels of pregnant women can become a parameter for the early screening of macrosomia.

Key words: Glycated hemoglobin A1c, Glycated albumin, Gestational diabetes mellitus, Neonates, Weight