HbA1c levels in non diabetic mothers with macrosomic and non macrosomic children

Abstract

Background: study motivated by the speculations about the probable etiology of the macrosomía in our locality. Physicians of the hospital have given warning about the frequent cases of macrosomic newborns. Before this study a five year retrospective revision was carried out looking at the care records and the corresponding clinical histories in the delivery rooms. The prevalence of macrosomía was 23.4% and gestational diabetes mellitus 1.5%.

Objective: to determine the behavior between the maternal levels of HbA1c and neonatal macrosomía.

Design: analytic observational study.

Setting: Hospital María Inmaculada. Florencia, Caquetá.

Participants: 120 non-diabetic patients to conform two groups of 60.

Interventions and measures: in the immediate postpartum HbA1c levels were determined. Group 1, mothers with non-macrosomic newborns (2500-3999g). Group 2, mothers with macrosomic newborns (>4000 g). Data on the number of children, maternal obesity (BMI>30 kg/m²), previous macrosomic infants and records of type 2 diabetes in first line were collected as well as those of the cesarean sections practiced in the women groups and the different causes that motivated them. HbA1c was determined by means of a Bayer DCA 2000 equipment.

Results: HbA1c average group 1: 4.39% (CI95:4.29%-4.49%), group 2: 5.61% (CI95%:5.54%-5.68%), p<0.001. Average weight of newborns in group 1:3153g (CI95:3067g-3239g), in group 2:4460g (CI95:4359g4560g), p<0.001. Coefficient correlation (r) group 1 HbA1c-weight: 0.194, p=0.068; r group 2: 0.77; p<0.001, r2=0.59. Cesarean section group 1 vs. 2: 38.3% vs. 70%, p=0.005. Family history of type 2 diabetes and macrosomía groups 1 vs. 2: 23.3% vs. 61.7% and 18.3% vs. 60%, for both ρ < 0.001.

Conclusions: mothers with macrosomic newborns had significantly higher HbA1c levels. Around 60% of the changes in terms of weight were correlated with the HbA1c levels. Family history of type 2 diabetes and macrosomía was important. In our locality we have seen an alteration in the homeostasis of the glucose. It is something that needs further clarification