Abdominal circumference profiles of macrosomic infants born to mothers with or      without hyperglycemia in China

Yan, Jie; Yang, Huixia; Wu, Meng; Wang, Yongqing; Liu, Shang; Cai, Zhen; Ji, Li-Ping; Wang, Yunfeng; Sun, Yingxian; Liu, Jiaxiu; Li, Wei; Sun, Yufeng; Zhang, Xueying; Luo, Tianxia; Chen, Hạixia; Yu, Lihua; Liu, Xinghui; Wang, Zilian; Chen, Haitian

doi:10.1080/14767058.2018.1487941

Cited by 6 publications

(5 citation statements)

References 31 publications

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“…Abdominal circumference is a biometric parameter that, given its wide range, has greater reliability in estimating fetal weight than gestational age, especially in the case of diabetes and pregnancy ( 14 , 15 ). It represents an important biometric parameter in determining gestational age in fetuses with head or leg malformation, given dubious reliability of other common parameters.…”

Section: Resultsmentioning

confidence: 99%

Ultrasound Diagnosis of Macrosomia among Women with Gestational Diabetes – Review of the Literature

Lovrić¹

2022

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Pregnancies burdened with gestational diabetes (GDM) are more likely to end in birth of a macrosomic child, where the frequency of operative termination of pregnancy is more common, accompanied with more complications and injuries of both mother and child in comparison to the general population. The need to calculate fetal weight right before delivery has led to the development of numerous methods for greater estimation accuracy. We reviewed the related literature from 1980 to 2020, using the terms macrosomia, ultrasound assessment, gestational diabetes, and relevant articles were considered in preparation of this article. The most frequently used methods are based on two-dimensional ultrasound measurements of individual fetal biometric parameters and their combination in a mathematical regression model. Some methods involve the addition of other mother and child conditions to increase reliability of the method in recognizing macrosomia. In daily work, especially with pregnant women suffering from GDM, it is necessary to have reliable data on the estimated fetal weight before making the correct clinical decision on how to terminate the pregnancy. In this regard, we bring a review of the literature related to the assessment of fetal macrosomia, especially in women with GDM.

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Section: Resultsmentioning

confidence: 99%

Ultrasound Diagnosis of Macrosomia among Women with Gestational Diabetes – Review of the Literature

Lovrić¹

2022

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“…In Table 1, the prevalence of macrosomia (> 4000 g) and LGA (>90th percentile) is described for 57 individual country‐time period data points across 16 Asian countries (Bangladesh, 20 Cambodia, 17 Hong Kong, 22–24 India, 17,25–28,111 Indonesia, 20 Japan, 29–39 Korea, 40–47 Malaysia, 48,49 Nepal, 17 Pakistan, 50,51 Philippines, 17 Singapore, 52 Sri Lanka, 17 Taiwan, 53–60 Thailand, 17,61–63 and Vietnam 17,64–66 . In Table 2, the prevalence of macrosomia (> 4000 g) and LGA (>90th percentile) is described for 47 individual data points across China 7,9,17,67–99,112,124 …”

Section: Resultsmentioning

confidence: 99%

Macrosomia and large for gestational age in Asia: One size does not fit all

Harvey

Elburg

Beek

2021

J of Obstet and Gynaecol

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Macrosomia, usually defined as infant birth weight of ≥4000 g, does not consider gestational age, sex, or country/region‐specific differences in mean birth weight and maternal body weight. This issue is particularly relevant for Asia, where 60% of the world's population lives, due to variations in maternal size and birth weights across populations. Large for gestational age (LGA), defined as birth weight > 90th centile, is a more sensitive measure as it considers gestational age and sex, though it is dependent on the choice of growth charts. We aimed to review reporting of macrosomia and LGA in Asia. We reviewed the literature on prevalence and risk of macrosomia and LGA in Asia over the last 29 years. Prevalence of macrosomia ranged from 0.5% (India) to 13.9% (China) while prevalence of LGA ranged from 4.3% (Korea) to 22.1% (China), indicating substantial variation in prevalence within and between Asian countries. High pre‐pregnancy body mass index, excessive gestational weight gain, and impaired glucose tolerance conferred risk of macrosomia/LGA. Incidence of macrosomia and LGA varies substantially within and between Asian countries, as do the growth charts and definitions. The latter makes it impossible to make comparisons but suggests differences in intrauterine growth between populations. Reporting LGA, using standardized country/regional growth charts, would better capture the incidence of high birth weight and allow for comparison and identification of contributing factors. Better understanding of local drivers of excessive intrauterine growth could enable development of improved strategies for prevention and management of LGA.

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“…In a Chinese prospective multicenter study of 8,272 DM cases and 729 pre-gestational DM cases, Yan et al showed that the growth rates assessed by means of AC were higher in the GDM and pre-gestational DM groups with macrosomic babies than in non-macrosomic groups, with statistically significant differences between groups older than 22 weeks of gestation ( p = 0.001). 9 In another cohort in South Africa, Macauley et al 29 followed up 741 women with serial ultrasound measurements and showed that AC among pregnant women with GDM (24–28 weeks) was significantly higher in all measurements, from 14 weeks to 38 weeks of gestational age, especially between 27 and 32 weeks ( p < 0.001), regardless of BMI (body mass index). 29 In addition, Brand et al 30 showed that, in a population of South Asian and English descendants, fetal growth accelerates after 24 weeks of age until birth in pregnant women with GDM, even before they are diagnosed with GDM.…”

Section: Discussionmentioning

confidence: 99%

“…7,8 The use of ultrasound scanning is fundamental to monitor fetal growth, especially when there is an increased risk of large for gestational age (LGA), as it occurs with diabetic mothers' fetuses. 9 Some of the parameters used for this estimate are the abdominal circumference (AC) and the estimated fetal weight (EFW). 9 Abdominal circumference is considered the earliest and, therefore, the most sensitive parameter in the evaluation of fetal macrosomia, reflecting liver growth abnormalities.…”

Section: Introductionmentioning

confidence: 99%

“… 9 Some of the parameters used for this estimate are the abdominal circumference (AC) and the estimated fetal weight (EFW). 9 Abdominal circumference is considered the earliest and, therefore, the most sensitive parameter in the evaluation of fetal macrosomia, reflecting liver growth abnormalities. 10 Estimated fetal weight is an indirect measurement calculated with formulas that use multiple biometric parameters, and it is subject to a higher percentage of errors.…”

Section: Introductionmentioning

confidence: 99%

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Agreement Analysis between Sonographic Estimates and Birth Weight, by the WHO and Intergrowth-21st Tables, in Newborns of Diabetic Mothers

Souza

Fróes

Cortêz

et al. 2021

Rev Bras Ginecol Obstet

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Objective To analyze the agreement, in relation to the 90th percentile, of ultrasound measurements of abdominal circumference (AC) and estimated fetal weight (EFW), between the World Health Organization (WHO) and the International Fetal and Newborn Growth Consortium for the 21st Century (intergrowth-21st) tables, as well as regarding birth weight in fetuses/newborns of diabetic mothers. Methods Retrospective study with data from medical records of 171 diabetic pregnant women, single pregnancies, followed between January 2017 and June 2018. Abdominal circumference and EFW data at admission (from 22 weeks) and predelivery (up to 3 weeks) were analyzed. These measures were classified in relation to the 90th percentile. The Kappa coefficient was used to analyze the agreement of these ultrasound variables between the WHO and intergrowth-21st tables, as well as, by reference table, these measurements and birth weight. Results The WHO study reported 21.6% large-for-gestational-age (LGA) newborns while the intergrowth-21st reported 32.2%. Both tables had strong concordances in the assessment of initial AC, final AC, and initial EFW (Kappa = 0.66, 0.72 and 0.63, respectively) and almost perfect concordance in relation to final EFW (Kappa = 0.91). Regarding birth weight, the best concordances were found for initial AC (WHO: Kappa = 0.35; intergrowth-21st: Kappa = 0.42) and with the final EFW (WHO: Kappa = 0.33; intergrowth- 21st: Kappa = 0.35). Conclusion The initial AC and final EFW were the parameters of best agreement regarding birth weight classification. The WHO and intergrowth-21st tables showed high agreement in the classification of ultrasound measurements in relation to the 90th percentile. Studies are needed to confirm whether any of these tables are superior in predicting short- and long-term negative outcomes in the LGA group.

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Abdominal circumference profiles of macrosomic infants born to mothers with or without hyperglycemia in China

Cited by 6 publications

References 31 publications

Ultrasound Diagnosis of Macrosomia among Women with Gestational Diabetes – Review of the Literature

Ultrasound Diagnosis of Macrosomia among Women with Gestational Diabetes – Review of the Literature

Macrosomia and large for gestational age in Asia: One size does not fit all

Agreement Analysis between Sonographic Estimates and Birth Weight, by the WHO and Intergrowth-21st Tables, in Newborns of Diabetic Mothers

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