Maternal obesity not maternal glucose values correlates best with high rates of fetal macrosomia in pregnancies complicated by gestational diabetes
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U. M. Schaefer-Graf
Abstract
Aim: The current therapeutic strategies to reduce macrosomia rates in gestational diabetes (GDM) have focused on the normalizing of maternal glucose levels. The aim of our study was 1.) to compare maternal glycemic values with the presence of fetal macrosomia at different gestational ages (GA) and with LGA at birth in a cohort of women with glucose intolerance and standard diabetic therapy.
Methods: 306 women with GDM and 97 with impaired glucose tolerance underwent ultrasound examinations at entry and, after initiation of therapy, monthly in addition to standard diabetic therapy. Measurements from the entry diagnostic oGTT, glucose profile and HbA1c and from subsequent glucose profiles obtained within 3 days of the ultrasound at 5 categories of GA age (20–23, 24–27 etc) were retrospectively compared between pregnancies with and without fetal macrosomia, defined as an abdominal circumference (AC) ≥90th percentile. Maternal prepregnancy BMI was adjusted for and BMI ≥30 kg/m2 was defined as obesity.
Results: At entry, neither the hourly oGTT values, HbA1c, nor the entry glucose profile differed significantly between pregnancies with and without fetal macrosomia. In a total of 919 pairs of ultrasound/glucose profiles there was no significant difference in glucose levels at every GA category neither in lean nor in obese woman except for the fasting glucose of 32–35 GA. The fetal macrosomia rate in each GA category and the rate of LGA were significantly higher in obese women: e.g. 14.5 vs 28% at diagnosis, 15.7 vs 26.7% at 32–35 weeks, 15.5 vs 25.0% at birth (p < 0.05 for each comparison).
Conclusion: The association of maternal glucose values and fetal macrosomia was limited to the fasting glucose values between 32–35 weeks while maternal obesity appeared to be a strong risk factor for macrosomia throughout pregnancies with GDM. In obese women the high fetal macrosomia rate did not appear to be normalized
Copyright © 2002 by Walter de Gruyter GmbH & Co. KG
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Articles in the same Issue
- Taurine and taurine-deficiency in the perinatal period
- The effect of betamethasone administration to pregnant women on maternal serum indicators of infection
- Chorioamnionitis: Elevated interleukin-6 and interleukin-8 concentrations in the lower uterine segment
- Tyrphostins inhibit lipopolysaccharide induced preterm labor in mice
- Amniotic fluid matrix metalloproteinase-8 and the development of cerebral palsy
- Echocardiographic screening for congenital heart disease: a randomized study
- Maternal obesity not maternal glucose values correlates best with high rates of fetal macrosomia in pregnancies complicated by gestational diabetes
- Increased endothelial thrombomodulin (TM) expression in pregnancies complicated by IUGR
- Serum amyloid A protein in the early detection of late-onset bacterial sepsis in preterm infants
- Carbon dioxide levels do not predict duration of home oxygen requirement: a retrospective study
- A congenital anterior diaphragmatic hernia with massive pericardial effusion requiring neither emergency pericardiocentesis nor operation. A case report and review of the literature
- Extravascular collection of fluid around the vertebra resulting from malpositioning of a peripherally inserted central venous catheter in extremely low birth weight infants
- Placental boost to varicella-zoster antibodies in the newborn
- Enhancing decision-making by depressed pregnant patients
- Congress Calendar
- WAPM-Newsletter No 2/2002
