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Am J Perinatol 2024; 41(02): 115-121
DOI: 10.1055/s-0043-1772746
SMFM Fellowship Series Article

Glycated Albumin and Glycemia in Pregnancy and Postpartum: A Pilot Study

Marti D. Soffer 
1   Harvard Medical School, Boston, Massachusetts
2   Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Biology, Massachusetts General Hospital, Boston, Massachusetts
,
Kaitlyn E. James
1   Harvard Medical School, Boston, Massachusetts
3   Department of Obstetrics, Gynecology, and Reproductive Biology, Massachusetts General Hospital, Boston, Massachusetts
4   Deborah Kelly Center for Outcomes Research, Massachusetts General Hospital, Boston, Massachusetts
,
Tanayott Thaweethai
1   Harvard Medical School, Boston, Massachusetts
5   Department of Biostatistics, Biostatistics, Massachusetts General Hospital, Boston, Massachusetts
,
Michael Callahan
6   Diabetes Unit, Massachusetts General Hospital, Boston, Massachusetts
,
William H. Barth Jr.
1   Harvard Medical School, Boston, Massachusetts
2   Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Biology, Massachusetts General Hospital, Boston, Massachusetts
,
Camille E. Powe
1   Harvard Medical School, Boston, Massachusetts
3   Department of Obstetrics, Gynecology, and Reproductive Biology, Massachusetts General Hospital, Boston, Massachusetts
5   Department of Biostatistics, Biostatistics, Massachusetts General Hospital, Boston, Massachusetts
6   Diabetes Unit, Massachusetts General Hospital, Boston, Massachusetts
7   Broad Institute, Cambridge, Massachusetts
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Funding Research reported in this manuscript was supported by the National Institutes of Health under award number NIDDK K23DK113218 and the Robert Wood Johnson Foundation's Harold Amos Medical Faculty Development Program. Data collection was also supported by the Clinical Research Center at Massachusetts General Hospital under grant number 1UL1TR002541-01. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources, the National Center for Advancing Translational Science, or the National Institutes of Health. Additional funding support was provided by the Department of Obstetrics, Gynecology, and Reproductive Biology at Massachusetts General Hospital.
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Abstract

Objective Percent glycated albumin (%GAlb) is a marker of glycemia over the past 2 to 3 weeks in nonpregnant individuals. Longitudinal changes in %GAlb extending throughout pregnancy and postpartum (PP) have not been described. We aimed to describe levels of %GAlb throughout pregnancy and PP and relationships with glycemia.

Study Design Fifty women among those in the Study of Pregnancy Regulation of INsulin and Glucose cohort underwent 75-g oral glucose tolerance tests (OGTTs) at a mean of 13 weeks (V1) and 26 weeks (V2) of gestation and 11 weeks' PP. %GAlb was measured on frozen plasma samples.

Results Total albumin decreased from V1 to V2 and increased PP to levels higher than at V1. %GAlb declined between V1 and V2 (β = − 0.63% 95% CI [−0.8, −0.6] p < 0.001) and remained stable between V2 and PP (β = − 0.04% [−0.3, 0.2] p = 0.78). Body mass index (BMI) was inversely related to %GAlb in pregnancy (V1: rho = − 0.5, p = 0.0001; V2 rho = − 0.4, p = 0.006), but not PP (rho = − 0.15, p = 0.31). The longitudinal changes in %GAlb persisted after adjusting for BMI. Neither glycemia measurements nor hemoglobin A1c were associated with %GAlb at any time point, and adjustments for BMI did not reveal additional associations.

Conclusion %GAlb decreases between early and late gestation and remains decreased PP, despite a PP increase in total albumin above early pregnancy values. Given the lack of correlation with OGTT values or A1c, %GAlb is unlikely to be useful in assessing glycemia in pregnant or PP women.

Key Points

  • Changes in %GAlb extending to the postpartum period have not been described.

  • %GAlb decreases in pregnancy and remains decreased postpartum, despite a postpartum increase in total albumin above early pregnancy values.

  • Glycemia measurements nor A1c were associated with %GAlb at any time point, therefore, %GAlb is unlikely to be useful in assessing glycemia in pregnant or postpartum women.

Keywords

gestational diabetes - gestational glycemia - glycated albumin - pregnancy biomarkers - postpartum diabetes - postpartum screening

Note

This work was presented at the American Diabetes Association (ADA) Annual Meeting, held virtually in June 2021.




Publikationsverlauf

Eingereicht: 08. Februar 2023

Angenommen: 21. Juli 2023

Artikel online veröffentlicht:
28. August 2023

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