Frisoli G, Naranjo L, Shehab N
Am J Perinatol. 1985 Jul;2(3):183-8. doi: 10.1055/s-2007-999945.
Glycosylated hemoglobin (HbA1) concentration was measured in 155 pre- and 30 postpartum patients to study its correlation with glucose metabolism and perinatal outcome in patients suspected of carbohydrate intolerance during pregnancy. Though the mean HbA1 values were significantly higher in gestational diabetics compared to normal pregnant controls, the large overlap between HbA1 levels of diabetic patients and levels in the of normal range, make HbA1 an unreliable screening device for diabetes. However, if the HbA1 level was elevated in patients suspected of carbohydrate intolerance, but who had a normal glucose tolerance test, the perinatal outcome in terms of macrosomia and neonatal metabolic abnormalities was similar to that of the group with gestational diabetes. HbA1 measurements should be obtained in these women, and, if elevated, maternal and fetal surveillance is recommended. HbA1 level is not a useful predictor of birthweight, though may be of value as a postpartum screen for unrecognized diabetes and may help discriminate between a constitutionally large but otherwise normal newborn and a large infant of a diabetic mother.
对155例产前和30例产后患者进行糖化血红蛋白（HbA1）浓度测定，以研究其与妊娠期间疑似碳水化合物不耐受患者的葡萄糖代谢及围产期结局的相关性。尽管与正常妊娠对照组相比，妊娠期糖尿病患者的平均HbA1值显著更高，但糖尿病患者的HbA1水平与正常范围水平之间存在较大重叠，这使得HbA1成为一种不可靠的糖尿病筛查指标。然而，如果疑似碳水化合物不耐受但葡萄糖耐量试验正常的患者HbA1水平升高，那么在巨大儿和新生儿代谢异常方面的围产期结局与妊娠期糖尿病组相似。这些女性应进行HbA1测量，如果升高，建议对母婴进行监测。HbA1水平不是出生体重的有用预测指标，不过它可能作为产后未被识别糖尿病的筛查指标具有价值，并且可能有助于区分体质上较大但其他方面正常的新生儿与糖尿病母亲所生的巨大儿。
