Maternal obesity not maternal glucose values correlates best with high rates of fetal macrosomia in pregnancies complicated by gestational diabetes

Schaefer-Graf, Ute M.; Heuer, R.; Kilavuz, Ö.; Pandura, Angela; Henrich, Wolfgang; Vetter, K.

doi:10.1515/jpm.2002.046

Cited by 74 publications

(76 citation statements)

References 29 publications

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“…So, FPG is a simple indicator for identifying high risk women with GDM. Earlier reports noted that the fasting glucose value was better than the postchallenge glucose levels in identifying LGA risk (21,24,25). Similarly, Retnakaran and cols.…”

Section: Discussionmentioning

confidence: 88%

Maternal 75-g OGTT glucose levels as predictive factors for large-for-gestational age newborns in women with gestational diabetes mellitus

Krstevska¹,

Valentina

Slagjana³

et al. 2016

Arch. Endocrinol. Metab.

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Objective: Our goal was to investigate which glucose measurement from the 75-g oral glucose tolerance test (OGTT) has more capability of predicting large for-gestational-age (LGA) newborns of mothers with gestational diabetes mellitus (GDM). Subjects and methods: The study group consisted of 118 consecutively pregnant women with singleton pregnancy, patients of Outpatients Department of the Endocrinology, Diabetes, and Metabolic Disorders Clinic. All were prospectively screened for GDM between 24 th and 28 th week of pregnancy and followed to delivery. Outcome measures included: patients' ages, pre-pregnancy BMI, BMI before delivery, FPG, 1 and 2 hour OGTT glucose values, haemoglobin A1c at third trimester, gestational week of delivery, mode of delivery and baby birth weight. Results: From 118 pregnancies, 78 (66.1%) women were with GDM, and 40 (33.9%) without GDM. There were statistically significant differences (30.7 versus 5.0%, p < 0.01) between LGA newborns from GDM and control group, respectively. Gestation week of delivery and fasting glucose levels were independent predictors for LGA (Beta = 0.58 and Beta = 0.37 respectively, p < 0.01). Areas under the receiver operator characteristic curve (AUC) were compared for the prediction of LGA (0.

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Section: Discussionmentioning

confidence: 88%

Maternal 75-g OGTT glucose levels as predictive factors for large-for-gestational age newborns in women with gestational diabetes mellitus

Krstevska¹,

Valentina

Slagjana³

et al. 2016

Arch. Endocrinol. Metab.

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“…Among more than 38 000 deliveries, obese women were significantly more likely to have babies with a cardiac anomaly (odds ratio (OR) 6.5; 95% confidence interval (95% CI) 1.2-34.9; P ¼ 0.025). Two studies by Shaw et al 6,8 found an increased risk for neural tube defects in the offspring of obese women. In addition, there is a known correlation between maternal obesity and diabetes, which also carries increased risk for fetal anomalies.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, there is a known correlation between maternal obesity and diabetes, which also carries increased risk for fetal anomalies. 3,6 Finally, Schwarzler et al 19 randomized 1206 women and compared the ability to complete the fetal anatomy scan at 18, 20, or 22 weeks. They concluded that in an unselected population, second-trimester ultrasound screening at 20-22 weeks rather than 18 weeks was easier to perform and less likely to require an additional scan.…”

Section: Discussionmentioning

confidence: 99%

“…2 Maternal obesity, independent of diabetes, has been associated with an increased risk for fetal structural anomalies; primarily neural tube and cardiac defects. [3][4][5][6][7][8][9][10][11][12] Thus, the ability to visualize adequately these structures at midtrimester prenatal ultrasound examination has significant clinical implications.…”

Section: Introductionmentioning

confidence: 99%

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The impact of maternal obesity on midtrimester sonographic visualization of fetal cardiac and craniospinal structures

et al. 2004

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OBJECTIVE:To examine the impact of maternal obesity on the rate of suboptimal ultrasound visualization (SUV) of fetal anatomy and determine the optimal timing of prenatal ultrasound examination for the obese gravida. METHODS: A computerized ultrasound database was used to identify ultrasound examinations for singleton gestations performed between 14 0/7 and 23 6/7 weeks at a tertiary care, university-based hospital. Patients were divided into four groups and categorized based on body mass index (BMI): nonobese (BMI o30 kg/m 2 ), class I obesity (30rBMIo35 kg/m 2 ), class II obesity (35rBMIo40 kg/m 2 ), and extreme obesity (BMI Z40 kg/m 2 ). The rates of SUV for fetal cardiac and craniospinal structures were calculated for each group and compared. RESULTS: A total of 11 019 pregnancies were studied, of which 38.6% of the patients were obese. Overall, the rate of SUV of the fetal structures was higher for obese compared to nonobese women for both cardiac (37. With increasing gestational age at examination, the rate of SUV decreased for both obese and nonobese women. However, for obese women there was minimal improvement in visualization after 18-20 weeks. Even after adjustment for gestational age and the type of ultrasound machine, obese women (class I, class II, and extreme obesity) were still associated with increased odds for SUV of the fetal cardiac and craniospinal structures compared to nonobese women. CONCLUSION: Maternal obesity increases the rate of SUV for the fetal cardiac structures by 49.8% and for the craniospinal structures by 31%. The optimal gestational age for visualization of fetal cardiac and craniospinal anatomy in obese patients may be after 18-20 weeks.

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“…Among the non-diabetic population, the sex of the infant, and maternal age, parity and time since last pregnancy have been shown to explain about 20% of the variance in birthweight [22]. The birthweight of the parents and maternal pre-pregnancy BMI have also been shown to correlate with the birthweight of the offspring [8,[35][36][37]. In the present study, maternal BMI, maternal age and time elapsed since last pregnancy were not significantly related to the birthweight of the second-born infant.…”

Section: Discussionmentioning

confidence: 99%

Sibling birthweight as a predictor of macrosomia in women with type 1 diabetes

2005

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Aims/hypothesis: The aim of this study was to establish the value of maternal HbA 1 c levels and older sibling birthweight as predictors of birthweight and macrosomia in the offspring of women with type 1 diabetes. Subjects and methods: A total of 214 pregnancies of 107 women with type 1 diabetes were studied. Regression analysis was performed to test the predictive value of the birthweight of the first-born infant, HbA 1 c levels, maternal BMI, maternal age and time between subsequent births on the birthweight of the second-born infant. Birthweights were corrected for sex and gestational age. The percentages of first-and second-born infants with macrosomia (weight >90th centile) were calculated and compared. Results: Only the birthweight of earlier born infants was significantly related to that of second-born infants (p<0.001) and 40-50% of the variation in the birthweight of second-born infants could be explained by the birthweight of the firstborn infants. About 85% of the mothers who gave birth to a macrosomic infant had a macrosomic infant in a subsequent pregnancy. Conclusions/interpretation: Although it is clear that glycaemic control contributes to birthweight in women with type 1 diabetes, the birthweight of an earlier born infant appears to be a much better predictor of the birthweight of a subsequent infant than HbA 1 c levels during pregnancy. It may, therefore, be used to identify patients at risk of giving birth to a macrosomic infant. Daily home monitoring of glucose levels, rather than HbA 1 c levels, should be used for assessment of maternal glycaemia during pregnancy.

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Maternal obesity not maternal glucose values correlates best with high rates of fetal macrosomia in pregnancies complicated by gestational diabetes

Cited by 74 publications

References 29 publications

Maternal 75-g OGTT glucose levels as predictive factors for large-for-gestational age newborns in women with gestational diabetes mellitus

Maternal 75-g OGTT glucose levels as predictive factors for large-for-gestational age newborns in women with gestational diabetes mellitus

The impact of maternal obesity on midtrimester sonographic visualization of fetal cardiac and craniospinal structures

Sibling birthweight as a predictor of macrosomia in women with type 1 diabetes

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