Glycosylated hemoglobin as a predictor of fetal pulmonic maturity in insulin-dependent diabetes at term.
In insulin dependent diabetic (IDDM) gestations, fetal pulmonary maturity is delayed in the presence of suboptimal glycemic control. Serum glycosylated hemoglobin (HbA1c) provides a means of assessing glycemic control. We evaluated maternal HbA1c in IDDM pregnancies at term undergoing amniocentesis for lung maturity to establish if euglycemia is associated with improved fetal lung maturity. Between July 1995 and June 1996, IDDM patients undergoing amniocentesis at term for lung maturity studies had a maternal serum sample analyzed for HbA1c. Fetal lung maturity was established by the presence of phosphatidylglycerol (PG) in amniotic fluid. HbA1c was considered elevated if >6.2%. Mean HbA1c level was 6.8% (range 4.4 to 9.9%). PG was present in 54% of patients with elevated HbA1c (7/13) versus 80% of those with normal HbA1c (8/10) (p = 0.4). Although birth weight was higher in the elevated than in the normal HbA1c group (3770 +/- 514 vs. 3215 +/- 610 g), no association was present between birth weight and HbA1c level (r = 0.22, p = 0.4). The rate of a mature pulmonic profile at term is not significantly different between IDDM women with good or poor glycemic control. HbA1c values should not be used to predict the presence or absence of amniotic fluid PG.
Heimberger
C M
CM
Department of Obstetrics and Gynecology, Georgetown University Medical Center, Washington, DC 20007, USA.
Ghidini
A
A
Lewis
K M
KM
Spong
C Y
CY
D000328:Adult; D000653:Amniotic Fluid / Q000737:chemistry; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D005260:Female; D005325:Fetal Organ Maturity; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008168:Lung / Q000196:embryology* / Q000502:physiology; D010715:Phosphatidylglycerols / Q000032:analysis; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood*; D011446:Prospective Studies
D006442:Glycated Hemoglobin; D010715:Phosphatidylglycerols