Value of maternal fructosamine in the screening of an unselected population for hyperglycemia-related complications in the newborn.
The relationship between the maternal serum fructosamine concentration and pregnancy outcome was studied in 765 consecutive subjects of an obstetric community hospital population. The neonatal outcome of patients with a fructosamine concentration in pregnancy below and above 2.30 mmol/L were compared. Patients with a fructosamine concentration above 2.30 mmol/L did not show an increased incidence of neonatal hypoglycemia, hyperbilirubinemia, or respiratory distress syndrome. On the other hand, they did give birth to infants with a higher birthweight ratio, a variable defined as newborn weight corrected for sex, gestational age, and parity. However, the predictive value with respect to birthweight ratio was modest: Fructosamine accounted for only 1.4% of the variation in birthweight ratio, much less than other well-known contributors to this variation, such as smoking (10%) and prepregnancy maternal (6.5%) or paternal weight (2.8%). The screening value of fructosamine to identify patients who would give birth to a macrosomic infant was limited irrespective the gestational age at measurement. It is concluded that fructosamine determined during pregnancy in an unselected obstetric population is an unsuitable screening method to trace patients with an increased risk to deliver of an infant with neonatal complications of maternal hyperglycemia.
Salemans
T H
TH
Department of Obstetrics and Gynecology, De Wever and Gregorius Hospital, Heerlen/Brunssum, The Netherlands.
van Dieijen-Visser
M P
MP
Brombacher
P J
PJ
Peeters
L L
LL
D000328:Adult; D001724:Birth Weight; D016640:Diabetes, Gestational / Q000097:blood* / Q000453:epidemiology; D005260:Female; D019270:Fructosamine; D006595:Hexosamines / Q000097:blood*; D006801:Humans; D006943:Hyperglycemia / Q000097:blood* / Q000453:epidemiology; D007003:Hypoglycemia / Q000453:epidemiology*; D015994:Incidence; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000453:epidemiology*; D008403:Mass Screening / Q000379:methods; D011247:Pregnancy / Q000097:blood*; D011256:Pregnancy Outcome / Q000453:epidemiology; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology*; D012307:Risk Factors
D006595:Hexosamines; D019270:Fructosamine