RELATIONSHIP OF GLYCOSYLATED HEMOGLOBIN, FETAL MACROSOMIA, AND BIRTH-WEIGHT MACROSOMIA

被引：30

作者：

WYSE, LJ

JONES, M

MANDEL, F

机构：

[1] Division of Maternal Fetal Medicine, North Shore University Hospital, Cornell University Medical Center, Manhasset, New York

来源：

AMERICAN JOURNAL OF PERINATOLOGY | 1994年 / 11卷 / 04期

关键词：

DIABETES; GLYCOSYLATED HEMOGLOBIN; MACROSOMIA;

D O I：

10.1055/s-2007-994587

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

Previous studies have shown that glycosylated hemoglobin (Hb A(1C)) once elevated correlated with fetal malformations, poor perinatal outcome, and macrosomia. To determine whether Hb A(1C) was related to fetal diabetic complications such as polyhydramnios, fetal macrosomia, and fat line detected on ultrasonographic evaluation, 66 diabetic patient, types I, II, and III, were followed longitudinally. These ultrasound markers were further assessed regarding the reliability of predicting birthweight macrosomia. Fetal macrosomia and birthweight macrosomia were defined by weight greater than the 90th percentile for gestational age based on the Williams growth curve. The Hb A(1C) values were compared to women with and without fetal diabetic complications. Fetal diabetic complications occurred in 13 (20%) of the cases and birthweight macrosomia occurred in 19 (29%) of the cases. Of those 13 women with fetal diabetic complications, 11 (85%) had Hb A(1C) greater than 6.3%. This level was significantly different in women with the ultrasound markers vs those without. Ultrasound-determined macrosomia in predicting birthweight macrosomia has a sensitivity, specificity, positive and negative predictive values of 53%, 94%, 77%, and 83%, respectively. There is a critical level of Hb A(1C) at which ultrasound fetal diabetic markers were observed; this level is greater than 6.3%. We conclude that there is a target level of glycemic control that one must avoid to prevent birthweight macrosomia.

引用

页码：260 / 262

页数：3

共 17 条

[1]

Lucas L.J., Leveno K.J., Williams L., Et al., Early pregnancy glycosylated hemoglobin, severity of diabetes and fetal malformations, Am J Obstet Gynecol, 161, (1989)

[2]

Leslie R.D.G., Pyke D.A., John P.N., White J.M., Hemoglobin A., diabetic pregnancy, Lancet, 2, (1978)

[3]

Miller E., Hare J.W., Cloherty J.P., Et al., Elevated maternal hemoglobin A1c J in early pregnancy and major congenital anomalies in infants of diabetic mothers, N Engl J Med, 304, (1981)

[4]

Soler N.G., Walsh C.H., Malins J.M., Congenital malformations in infants of diabetic mothers, Q J Med, 45, (1976)

[5]

Miller E., Hare J.W., Cloherty J.P., Et al., Elevated maternal hemoglobin A1c J in early pregnancy and major congenital anomalies of infants, N Engl J Med, 304, (1981)

[6]

Gabbe S.G., Lowensohn R.I., Wu P.U., Guerra G., Current pat- terns of neonatal morbidity and mortality in infants of diabetic mothers, Diabetes Care, 1, (1978)

[7]

Kitzmiller J.L., Cloherty J.D., Younger M.D., Et al., Diabetic pregnancy and perinatal morbidity, Am J Obstet Gynecol, 131, (1978)

[8]

Skyler J.S., O#x0027

[9]

Sullivan MJ, Holsinger KK. The relationship between maternal glycemia and macrosomia. Diabetes Care, 3, (1980)

[10]

Bunn H.F., Huney D.N., Kamin S., Et al., The biosynthesis of hemoglobin A1c J show glycosylation of hemoglobin in vivo, J Clin Invest, 57, (1976)

← 1 2 →