Relationship between inflammatory markers, glycated hemoglobin and placental weight on fetal outcomes in women with gestational diabetes

• Published in: Archives of Endocrinology and Metabolism Vol. 63; no. 1; pp. 22 - 29
• Main Authors: Braga, Fernanda Oliveira, Negrato, Carlos Antonio, Matta, Maria de Fátima Bevilacqua da, Carneiro, João Régis Ivar, Gomes, Marília Brito
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Endocrinologia e Metabologia 01.02.2019; Brazilian Society of Endocrinology and Metabolism
• Subjects: Adult; Biomarkers - blood; C-Reactive Protein - analysis; cytokines; Diabetes, Gestational - blood; Female; Gestational diabetes; Glycated Hemoglobin - analysis; Humans; inflammation; Interleukin-6 - blood; Longitudinal Studies; macrosomia; Original; placenta; Placenta - pathology; Predictive Value of Tests; Pregnancy; Pregnancy Outcome; preterm birth; Prospective Studies; Tumor Necrosis Factor-alpha - blood
• ISSN: 2359-3997; 2359-4292; 2359-4292
• DOI: 10.20945/2359-3997000000099

The aim of this study was to evaluate the relationship between inflammatory cytokines, placental weight, glycated hemoglobin and adverse perinatal outcomes (APOs) in women with gestational diabetes mellitus (GDM). This was a prospective, longitudinal and observational study conducted from April 2004 to November 2005 in Bauru, Brazil. Included patients had singleton pregnancies and performed a 100 g OGTT and had the levels of C-reactive protein (CRP), interleukin (IL)-6, TNF alfa and glycated hemoglobin (HbA1c) determined at 24-28th gestation weeks. A total of 176 patients were included, of whom 78 had the diagnosis of GDM (44.3%). Multivariate analysis demonstrated that HbA1c, age, body mass index (BMI) and previous history of GDM were independent predictors for GDM diagnosis. ROC curve indicated that HbA1C levels ≥ 5.1% at 24-28 weeks gestation were associated with GDM. No difference was found in IL-6, tumor necrosis factor alpha (TNF-alpha) and CRP serum levels in women with and without GDM. Multivariate analysis showed that placental weight was significantly associated with APOs (p < 0.005), with a cut-off value of 610 grams as demonstrated by the ROC curve. Placental weight ≥ 610 grams and HbA1C ≥ 5.1% were found to be associated with APOs and GDM, respectively, and their evaluation should be part of prenatal care routine.