Thb. Salemans et al., VALUE OF MATERNAL FRUCTOSAMINE IN THE SCREENING OF AN UNSELECTED POPULATION FOR HYPERGLYCEMIA-RELATED COMPLICATIONS IN THE NEWBORN, American journal of perinatology, 11(1), 1994, pp. 4-8
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.