Fetal size monitoring in women with gestational diabetes and normal glucose tolerance.
Fetal biometry
Fetal size
Gestational diabetes mellitus
Large-for-gestational age
Obstetric ultrasound
Pregnancy
Journal
Acta diabetologica
ISSN: 1432-5233
Titre abrégé: Acta Diabetol
Pays: Germany
ID NLM: 9200299
Informations de publication
Date de publication:
20 Jul 2024
20 Jul 2024
Historique:
received:
17
04
2024
accepted:
25
06
2024
medline:
20
7
2024
pubmed:
20
7
2024
entrez:
20
7
2024
Statut:
aheadofprint
Résumé
To monitor fetal size and identify predictors for birthweight in women with gestational diabetes (GDM) and normal glucose tolerance (NGT). Cohort study of 1843 women universally screened for GDM, with routine ultrasounds each trimester. Women with GDM and NGT were categorized in subgroups by birthweight centile. Of the total cohort, 231 (12.5%) women were diagnosed with GDM. Fetal size, incidence of large-for-gestational age (LGA: 12.3% of GDM vs. 12.9% of NGT, p = 0.822) and small-for-gestational age (SGA) neonates (4.8% of GDM vs. 5.1% of NGT, p = 0.886) were similar between GDM and NGT. GDM women with LGA neonates were more insulin resistant at baseline and had more often estimated fetal weight (EFW) ≥ P90 on the 28-33 weeks ultrasound (p = 0.033) than those with AGA (appropriate-for-gestational age) neonates. Compared to NGT women with AGA neonates, those with LGA neonates were more often obese and multiparous, had higher fasting glycemia, a worse lipid profile, and higher insulin resistance between 24 -28 weeks, with more often excessive gestational weight gain. On the 28-33 weeks ultrasound, abdominal circumference ≥ P95 had a high positive predictive value for LGA neonates in GDM (100%), whereas, in both GDM and NGT, EFW ≥ P90 and ≤ P10 had a high negative predictive value for LGA and SGA neonates (> 88%), respectively. There were no differences in fetal size throughout pregnancy nor in LGA incidence between GDM and NGT women. EFW centile at 28-33 weeks correlated well with birthweight. This indicates that GDM treatment is effective and targeted ultrasound follow-up is useful. TRIAL REGISTRATION CLINICALTRIALS.GOV: NCT02036619. Registration date: January 15, 2014. https://clinicaltrials.gov/ct2/show/NCT02036619 .
Identifiants
pubmed: 39031189
doi: 10.1007/s00592-024-02330-0
pii: 10.1007/s00592-024-02330-0
doi:
Banques de données
ClinicalTrials.gov
['NCT02036619']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Belgian National Lottery
ID : Belgian National Lottery
Organisme : Fund of the Academic studies of UZ Leuven
ID : Fund of the Academic studies of UZ Leuven
Organisme : Fund Yvonne and Jacques François-de Meurs of the King Baudouin Foundation
ID : Fund Yvonne and Jacques François-de Meurs of the King Baudouin Foundation
Organisme : Fonds Wetenschappelijk Onderzoek
ID : Fonds Wetenschappelijk Onderzoek
Organisme : Fonds Wetenschappelijk Onderzoek
ID : Fonds Wetenschappelijk Onderzoek
Organisme : Fonds Wetenschappelijk Onderzoek
ID : Fonds Wetenschappelijk Onderzoek
Informations de copyright
© 2024. Springer-Verlag Italia S.r.l., part of Springer Nature.
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