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GLYCOHEMOGLOBIN (HbAIc): A PROGNOSTICATOR OF BIRTH WEIGHT IN INFANTS OF DIABETIC MOTHERS

Hemoglobins AIa-c (fast Hb), minor variants of HbA, are elevated in diabetes mellitus. Recent studies indicate a relationship of fast Hb's, especially HbAIc (glycosylated form) to hyperglycemia. AIc is most manifest in aged erythrocytes. Since infant oversize has been attributed to maternal hyperglycemia and fetal hyperinsulinemia, the relationship of hemoglobin HbAIc was examined relative to birth weight (actual and relative to gestational age) and maternal glucose tolerance. Fast Hb's were measured by the Amberlite IRC cation exchange technique. Control women (6), gestational diabetics (Kt1.13%/min) (8), and insulin dependent women (8) were studied in their 3rd trimester. When corrected for gestational age, birth wts. correlated (p<0.001) in a linear regression with both fast Hb (r = 0.69, n = 18) and HbAIc (r = 0.67, n = 14). Two women with advanced diabetic vascular disease had smaller infants relative to gestational age and were excluded because of possible placental insufficiency. Kt correlated in a significant manner (p<0.05) only with HbAIc for a linear regression (r = 0.59, n = 15). Third trimester glycohemoglobin determination in maternal diabetes is a good indicator of infant size relative to gestational age. Furthermore, it has potential as a screening test of gestational diabetes in the 3rd trimester and the immediate postpartum when maternal carbohydrate intolerance may have reverted to normal.