title: Correlation of serum fructosamine and recurrent pregnancy loss: Case-control study.
abstract: OBJECTIVE
  Pre-gestational diabetes is associated with an elevated risk of pregnancy loss, but it is unclear whether subclinical glucose intolerance is associated with pregnancy loss, especially recurrent pregnancy loss (RPL). The aim of this study was therefore to compare maternal serum fructosamine (a marker of glycemic control) in patients with and without RPL.
  
  
  METHODS
  A case-control study was carried out of 117 women with unexplained RPL, defined as two or more pregnancy losses with no more than one live birth, and 117 age-matched controls with at least one full-term uncomplicated pregnancy and no more than one pregnancy loss. No RPL patients or controls had a clinical diagnosis of pre-gestational or gestational diabetes. Maternal serum was analyzed for fructosamine on quantitative spectrophotometry.
  
  
  RESULTS
  Mean body mass index (BMI) of RPL patients was 26.0 ± 6.4 kg/m(2) compared with 26.6 ± 5.8 kg/m(2) (P = 0.40). Fructosamine was higher in women with RPL (224.1 ± 28.79 μmol/mL) compared with controls (188.9 ± 19.3 μmol/mL, P < 0.001). This difference persisted when RPL patients and controls were stratified by BMI. The proportion of women with elevated fructosamine considered diagnostic of diabetes (>285 μmol/L) was similar in RPL patients and controls.
  
  
  CONCLUSIONS
  The RPL patients and controls had a similar proportion of women with elevated fructosamine considered diagnostic of diabetes. Serum fructosamine was increased in women with RPL compared with controls. Thus, subclinical glucose intolerance may be associated with an increased risk of RPL. These data support further investigation into the mechanisms of RPL associated with glucose intolerance, but do not support testing for subclinical glucose intolerance in women with RPL.
authors.affiliation: Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah, USA.|Division of Maternal Fetal Medicine, Intermountain Medical Center, Murray, Utah, USA.
authors.forename: Stephanie T
authors.initials: ST
authors.lastname: Romero
authors.affiliation: Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah, USA.|Division of Maternal Fetal Medicine, Intermountain Medical Center, Murray, Utah, USA.
authors.forename: Rita
authors.initials: R
authors.lastname: Sharshiner
authors.affiliation: Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Stoddard
authors.affiliation: Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah, USA.|Division of Maternal Fetal Medicine, Intermountain Medical Center, Murray, Utah, USA.
authors.forename: D
authors.initials: D
authors.lastname: Ware Branch
authors.affiliation: Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah, USA.|Division of Maternal Fetal Medicine, Intermountain Medical Center, Murray, Utah, USA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Silver
mesh_terms: D000026:Abortion, Habitual / Q000097:blood* / Q000209:etiology; D000328:Adult; D016022:Case-Control Studies; D048909:Diabetes Complications / Q000097:blood*; D005260:Female; D019270:Fructosamine / Q000097:blood*; D018149:Glucose Intolerance / Q000097:blood* / Q000150:complications; D006801:Humans; D011247:Pregnancy; D012307:Risk Factors
chemical_list: D019270:Fructosamine
keywords: fructosamine; hyperglycemia; recurrent pregnancy loss; subclinical diabetes