VALUE OF MATERNAL FRUCTOSAMINE IN THE SCREENING OF AN UNSELECTED POPULATION FOR HYPERGLYCEMIA-RELATED COMPLICATIONS IN THE NEWBORN

The relationship between the maternal serum fructosamine concentration and pregnancy outcome was studied in 765 consecutive subjects of an o bstetric community hospital population. The neonatal outcome of patien ts with a fructosamine concentration in pregnancy below and above 2.30 mmol/L were compared. Patients with a fructosamine concentration abov e 2.30 mmol/L did not show an increased incidence of neonatal hypoglyc emia, hyperbilirubinemia, or respiratory distress syndrome. On the oth er hand, they did give birth to infants with a higher birthweight rati o, a variable defined as newborn weight corrected for sex, gestational age, and parity. However, the predictive value with respect to birthw eight ratio was modest: Fructosamine accounted for only 1.4% of the va riation in birthweight ratio, much less than other well-known contribu tors to this variation, such as smoking (10%) and prepregnancy materna l (6.5%) or paternal weight (2.8%). The screening value of fructosamin e to identify patients who would give birth to a macrosomic infant was limited irrespective the gestational age at measurement. It is conclu ded that fructosamine determined during pregnancy in an unselected obs tetric population is an unsuitable screening method to trace patients with an increased risk to deliver of an infant with neonatal complicat ions of maternal hyperglycemia.