Abstract: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 … Show more
“…Silva et al have also identified high levels of plasma glucose at the 2-hour measurement in the OGTT as one of the major independent risk factors for LGA newborns. 19 Brankica et al 35 and Ouzilleau et al 37 found high levels of fasting blood glucose to be better predictors, whereas Mello et al 38 showed that 1-hour blood glucose was the factor most closely associated with LGA newborns. 35,37,38…”
Section: Discussionmentioning
confidence: 99%
“…The occurrence of LGA newborns was significantly higher in the group of women with combined change in the OGTT (fasting þ after the dextrose load), even after the multivariate analysis. Brankica et al 35 found that the combination of fasting blood glucose and blood glucose 1 hour after the glucose load in the OGTT was a predictor of occurrence of LGA newborns. Pregnant women exhibiting this combination may be considered at increased risk because of the fact that they have two distinct changes, altered fasting glucose and glucose intolerance, which suggests impairment in two different metabolic pathways associated with the disease, dysfunction of pancreatic β cells and insulin resistance.…”
Objective Gestational diabetes mellitus (GDM) is associated with a higher risk of perinatal morbidity and mortality, and its main complication is the occurrence of large for gestational age (LGA) newborns. The present study aims to characterize pregnant women with GDM and to identify factors associated with the occurrence of LGA newborns in this population.
Methods A cross-sectional study was performed based on medical records of women whose prenatal care and delivery were performed at the Maternal and Child Unit of the Hospital Universitário of the Universidade Federal do Maranhão, state of Maranhão, Brazil. A total of 116 pregnant women diagnosed with GDM were included according to the criteria of the International Association of Diabetes and Pregnancy Study Groups (IADPSG).
Results The variables associated with LGA newborns after multivariate analysis were: obesity prior to pregnancy (OR = 11.6; 95% CI: 1.40–95.9), previous macrosomia (OR = 34.7; 95% CI: 4.08–295.3), high blood glucose levels in the 3rd trimester (OR = 2,67; 95% CI: 1.01–7.12) and combined change in the oral glucose tolerance test (OGTT) (fasting + postdextrose) (OR = 3.53; 95% CI: 1.25–14.2) = 1.17–10.6). Otherwise, insufficient weight gain during pregnancy reduced the risk for LGA newborns (OR = 0.04; 95% CI: 0.01–0.32).
Conclusion Obesity prior to pregnancy, previous macrosomia, high blood glucose levels in the 3rd trimester, and combined change in the OGTT were independent predictive factors for LGA newborns in pregnant women with GDM.
“…Silva et al have also identified high levels of plasma glucose at the 2-hour measurement in the OGTT as one of the major independent risk factors for LGA newborns. 19 Brankica et al 35 and Ouzilleau et al 37 found high levels of fasting blood glucose to be better predictors, whereas Mello et al 38 showed that 1-hour blood glucose was the factor most closely associated with LGA newborns. 35,37,38…”
Section: Discussionmentioning
confidence: 99%
“…The occurrence of LGA newborns was significantly higher in the group of women with combined change in the OGTT (fasting þ after the dextrose load), even after the multivariate analysis. Brankica et al 35 found that the combination of fasting blood glucose and blood glucose 1 hour after the glucose load in the OGTT was a predictor of occurrence of LGA newborns. Pregnant women exhibiting this combination may be considered at increased risk because of the fact that they have two distinct changes, altered fasting glucose and glucose intolerance, which suggests impairment in two different metabolic pathways associated with the disease, dysfunction of pancreatic β cells and insulin resistance.…”
Objective Gestational diabetes mellitus (GDM) is associated with a higher risk of perinatal morbidity and mortality, and its main complication is the occurrence of large for gestational age (LGA) newborns. The present study aims to characterize pregnant women with GDM and to identify factors associated with the occurrence of LGA newborns in this population.
Methods A cross-sectional study was performed based on medical records of women whose prenatal care and delivery were performed at the Maternal and Child Unit of the Hospital Universitário of the Universidade Federal do Maranhão, state of Maranhão, Brazil. A total of 116 pregnant women diagnosed with GDM were included according to the criteria of the International Association of Diabetes and Pregnancy Study Groups (IADPSG).
Results The variables associated with LGA newborns after multivariate analysis were: obesity prior to pregnancy (OR = 11.6; 95% CI: 1.40–95.9), previous macrosomia (OR = 34.7; 95% CI: 4.08–295.3), high blood glucose levels in the 3rd trimester (OR = 2,67; 95% CI: 1.01–7.12) and combined change in the oral glucose tolerance test (OGTT) (fasting + postdextrose) (OR = 3.53; 95% CI: 1.25–14.2) = 1.17–10.6). Otherwise, insufficient weight gain during pregnancy reduced the risk for LGA newborns (OR = 0.04; 95% CI: 0.01–0.32).
Conclusion Obesity prior to pregnancy, previous macrosomia, high blood glucose levels in the 3rd trimester, and combined change in the OGTT were independent predictive factors for LGA newborns in pregnant women with GDM.
“…A Chinese study reported that between January 2016 and July 2016, 21.8% pregnant women were diagnosed with GDM based upon the criteria of the International Association of Diabetes and Pregnancy Study Groups (IADPSG) in some areas 15 . Most studies have investigated the relationship between GDM and gestational outcome 16 , 17 , which suggested that infants born to GDM mothers had higher weight or greater risk of large for gestational age (LGA). However, there exist some problems in the previous studies.…”
To investigate the effects of maternal fasting plasma glucose (FPG) and pre-pregnancy weight status (PPWS) on offspring birth measures and body mass index z-score (BMI-z) in the first year, we conducted a prospective study of 1,096 mother-infant dyads in Guangdong, China, 2014–2015. Multivariate logistic regression was used to test independent/interaction associations of maternal FPG and PPWS with macrosomia/large for gestational age (LGA). Association of PPWS and FPG with offspring BMI-z in the first year was assessed by the linear mixed effects models. For each 1-mmol/L increase in FPG, the risk of macrosomia and LGA was elevated by 2.74 and 2.01 (95% CI: 1.85, 7.60 and 1.54, 5.88), respectively. No main effect of PPWS or interaction association of FPG and PPWS on macrosomia/LGA was observed (P > 0.05). A relation between maternal FPG and PPWS was detected (P < 0.05). Infants of Q5 FPG mothers, those who were born to OWO mothers, had a 0.35 increase in the BMI-z (95% CI: 0.16, 0.55) compared with infants of NW mothers. In conclusion, maternal FPG is positively associated with macrosomia/LGA. Maternal PPWS and FPG considerably interacted for the association with the risk of offspring high BMI-z in the first year.
“…11 Abdalrahman et al have concluded from their study that gestational diabetes mellitus, even when controlled also can lead to higher number of LGA babies. 12 In our current study also there was a significant association of LGA babies in pregnant women with gestational diabetes (p=0.05).…”
INTRODUCTIONFoetal macrosomia is a common obstetrical problem affecting 20% babies born at term.1 Conventionally babies with birth weight more than 90th percentile is considered to be large for gestational age and those between 5 th and 90 th percentile as appropriate for gestational age. The birth weight cut-off may be based on absolute birth weight or greater than a particular percentile for the babies of that gestational age.2 Large for gestational age babies can lead to complications during delivery like prolonged labour, shoulder dystocia, birth injuries, post-partum haemorrhage, increased need for caesarean sections for cephalopelvic disproportion, anaesthetic complications and thromboembolic events. Also neonatal adverse outcomes of hypoglycemia, hypomagnesemia and hyperbilirubinemia are more common in these babies. 4 Antenatal detection of large for gestational age foetus will be helpful in anticipating these complications. This study is undertaken to determine the maternal factors associated with this condition so that the complications can be anticipated and managed in a better manner if not prevented.
METHODSThis study was conducted in a tertiary care center based on collection of retrospective data about large for gestational age (LGA) babies born over a period of one year. The inclusion criteria were singleton pregnancies which resulted in LGA babies over this period of time. All the mothers who delivered babies who were large for ABSTRACT Background: Large for gestational age (LGA) babies are known to have a higher incidence of birth trauma, difficult delivery and Caesarean sections. Knowledge about maternal factors associated with this can help in prediction and prevention of complications. Methods: Maternal factors in 112 cases of LGA babies was studied along with its outcome and compared with an equal number of controls. Results: 0.05% deliveries resulted in LGA babies. Age and parity were not significantly different in the two groups and so were the associated medical disorders of hypothyroidism and gestational hypertension. Significant association was found with post-dated pregnancies (p=0.04) and gestational diabetes mellitus (p=0.05). Also, higher number of primary Caesarean sections resulted in the case group. Conclusions: Post dated pregnancies and gestational diabetes were maternal factors associated with LGA babies and higher number of primary Caesarean sections resulted in these cases.
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