Hemoglobin A1c and Umbilical Cord Components: Prediction of Fetal Macrosomia in Women with Gestational Diabetes Mellitus

Objectives: This study aims to understand the importance of the glycated hemoglobin (HbA1c ) levels and umbilical cord components in prediction of fetal macrosomia. Methods: Ninety pregnant women (45 women with diabetes mellitus and 45 women with no diabetes mellitus) were chosen to measure the HbA1c level and ultrasound umbilical cord components during their 36th to 37th weeks of pregnancy. Results: Significantly higher (p<0.01) HbA1c levels, with higher umbilical cord components (Wharton’s jelly) (p<0.01) were observed in macrosomic fetus of diabetic women compared with control group. 16 of 45 (36%) of diabetic women had macrosomic fetuses; 11 of them had HbA1c >45 mmol/mol and 5 women had normal HbA1c levels. 12 of 45 (27%) of non-diabetic women had constitutionally macrosomic fetuses with normal HbA1c levels. Conclusions: The relationship between the umbilical cord components and the birth weight was not specific for the diabetic group. Macrosomic fetuses could be predicted more accurately by the combination of both birth weight and the umbilical cord components (i.e. Wharton’s jelly).