Abstract
PURPOSE: To evaluate the predictive efficacy of serum D-Dimer (D-D), Glycated Serum Protein (GSP), and HbA1c levels for macrosomia in Gestational Diabetes Mellitus (GDM). METHODS: A retrospective analysis was conducted on 224 pregnant women diagnosed with GDM from January 2021 to July 2024. Based on neonatal birth weight, 112 women were assigned to the macrosomia group, and 112 women with normal birth weight infants were assigned to the normal group. Serum levels of D-D, GSP, and HbA1c were measured and compared between the two groups. Binary regression analysis and ROC curve analysis were performed to assess the relationship between these biomarkers and the risk of macrosomia. RESULTS: The macrosomia group had significantly higher levels of D-D (4.90 vs 2.98 mg/L), GSP (3.49 vs 3.07 μmol/L), HbA1c (7.49% vs 5.85%), and HOMA-IR (4.35 vs 3.84) compared to the normal group (all p<0.001). Multivariate regression analysis revealed that D-Dimer (OR = 2.374), Glycated Serum Protein (GSP, OR = 31.890), and HbA1c (OR = 2.482) were significantly associated with the occurrence of macrosomia, even after adjusting for confounders including BMI. ROC curve analysis demonstrated that the combined detection of D-D, GSP, and HbA1c had an AUC of 0.9241, with a sensitivity of 83.93% and specificity of 86.61%, providing higher diagnostic accuracy than single biomarkers. CONCLUSION: Serum D-D, GSP, and HbA1c levels are significant factors in predicting macrosomia in GDM pregnancies. The combined use of these markers can improve diagnostic accuracy and serve as a valuable tool for early identification of high-risk pregnancies in clinical practice.