The Skin Autofluorescence of Pregnant Women with Diabetes Predicts Macrosomia in Their Newborns

Advanced Glycation End-products accumulated during long-term hyperglycaemia can be detected by measuring the Skin Autofluorescence (SAF). As pregestational and early gestational diabetes especially predispose to macrosomia, we sought whether the SAF of pregnant women with diabetes predicted macrosomia in their newborns. During years 2013-2015, we measured SAF (AGE-Reader, Diagnoptics, Groningen) at 25±7 weeks of amenorrhea in women with singleton pregnancies and diabetes. The birth weights and centiles according to gestational ages were recorded. Macrosomia was defined by birth weight ≥ 4000g and/or Large for Gestational Age ≥ 90 centile. The relation between SAF and macrosomia was tested by binary logistic regression analysis, adjusted for the other risk factors for macrosomia: maternal age and BMI, parity, and the type of diabetes (pregestational, early and late gestational diabetes mellitus). Two hundred and twelve women participated to the study: 16 pregestational, 75 early and 121 late gestational diabetes. They were 33±5 years old, their pregestational BMI were 27.2±6.9 kg/m², and 1were nulliparous. The birth weights were 3160±550 g, and 23 newborns were macrosomic (10.8%). Mothers of macrosomic newborn had higher SAF: 2.04±0.31 AU vs. 1.83±0.34 for other mothers (p<0.005). By binary logistic regression, the relation between SAF and macrosomia was significant (OR: 3.47; 95% CI: 1.01-11.86) after adjusting for maternal age (OR:1.13; 95% CI: 1.02-1.26) and for the type of diabetes (pregestational: OR: 5.97; 95% CI:1.51-23.54). This relation kept significant (OR: 4.21; 95% CI:1.13-15.67) after introducing the HbA1C in the model, available for 163 women. The skin autofluorescence, a marker of glycaemic memory, is higher in pregnant women with diabetes who will deliver a macrosomic newborn.