Glycohemoglobin in postpartum women

Abstract

As women giving birth to large for gestational age (LGA) infants are at risk for glucose intolerance during pregnancy, fasting plasma glucose (FPG) and glycohemoglobin levels (Hb AIc) were studied in the immediate postpartum period (less than 10 days). These laboratory tests, in addition to infant birth weights and perinatal histories in a group of 146 women whose infants were above the 95th percentile for gestational age, were compared with those of a group of women whose infants were appropriate for gestational age (AGA: above the 25th percentile but below the mothers 75th percentile) as well as with those of a group of control mothers without diabetic risk factors. Mean Hb AIc and FPG were elevated in the mothers of the LGA infants. When either the LGA group alone or all 3 groups together were analyzed by linear regression, significant relationships were observed for maternal Hb AIc versus FPG (P less than .001); maternal Hb AIc versus birth weight corrected for gestational age (P less than .001); and maternal FPG versus birth weight corrected for gestational age (P less than .001). In addition, infant weight correlated with maternal prepregnancy weight (r = .36), maternal weight gain in pregnancy (r = .23), and maternal height (r = .17), but not with any of the paternal anthropometric features studied. Twenty-six women with LGA infants underwent postpartum oral glucose tolerance tests before discharge. Four had abnormal results and all had Hb AIc values above SD of the nonrisk control values (5.8% total Hb). Of the 16 mothers of LGA infants with FPG levels greater than 85 mg/dl (above SD of the nonrisk control values), 7 (44%) also had Hb AIc levels of more than 5.8%. Moreover, on retrospective analysis, the LGA infants manifested increased perinatal morbidity (P less than .05) compared to the combined control groups.