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Maternal and Cord Serum Glycosylated Protein in Neonatal Macrosomia and Correlation With Birth Weight

From the Division of Neonatology, Department of Pediatrics, Cook County Hospital, University of Illinois College of Medicine; and the Hektoen Institute for Medical Research, Chicago, Illinois

Abstract

Maternal glycosylated hemoglobin and glycosylated protein and cord glycosylated protein were measured at delivery in 20 normal mothers of 20 macrosomic neonates over 4000 g (group I) and compared with values in two groups of mother/infant pairs: 20 normal/20 appropriate for gestational age (group II) and nine diabetic mothers/ten neonates (group III). Infants in group I, by design, weighed more (mean ± SD 4403 ± 337 g) than those in group II (2902 ± 278 g) or group III (3365 ± 898 g) (P<.001). There was no significant difference in weight between group II and group HI infants. Birth weight ratio was greater (P < .001) in group I than in group II or group III (1.39 ± 0.1, 0.9 ± 0.08, and 1.08 ± 0.25, respectively); group III infants had a higher birth weight ratio (P < .05) than those in group II. Hematocrit (%) was higher (P < .05) in group III (62 ± 3) than in group I (59 ± 5) or group II (57 ± 6) infants. Glycosylated hemoglobin values were similar in all three groups. Mean serum glycosylated protein was higher (P<.001) in group III (13.8 ± 2%) than in group I (10 ± 2%) or group II (9.8 ± 2.5%) mothers. Cord glycosylated protein was also higher (P < .001) in group III (12.3 ± 1.9%) than in group I (9 ± 1.3%) or group II (8.6 ± 1.7%) neonates. Maternal glycosylated protein correlated (P<.001; r=0.825) with cord glycosylated protein in the combined groups; the correlation was also significant within group I and group II, but not within group III pairs. Maternal glycosylated hemoglobin and glycosylated protein and cord glycosylated protein correlated poorly with birth weight, birth weight ratio, and 1-hour neonatal plasma glucose. Birth weight was significantly related to weight gain during pregnancy (R2=0.31, b'=0.53; P<.001) and gestational age (AK2=0.13, b'=0.37; P<.01). In summary, glycosylated protein is a good indicator of recent glycemic control in diabetic mothers and their neonates; glycosylated protein and glycosylated hemoglobin are not significantly correlated with birth weight, birth weight ratio, or glucose levels in the neonate.