scholarly journals Third trimester HbA1c and the association with large-for-gestational-age neonates in women with gestational diabetes

2021 ◽  
Author(s):  
Liliana Fonseca ◽  
Miguel Saraiva ◽  
Ana Amado ◽  
Sílvia Paredes ◽  
Fernando Pichel ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Gestational Age ◽  
Large For Gestational Age ◽  
Third Trimester

scholarly journals Accuracy of Third Trimester Ultrasound for Predicting Large-for-Gestational Age Newborn in Women with Gestational Diabetes Mellitus

2021 ◽  
Vol 73 (5) ◽  
Author(s):  
Pornpimol Ruangvutilert ◽  
Thanapa Rekhawasin ◽  
Chayawat Phatihattakorn ◽  
Dittakarn Boriboonhirunsarn
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Gestational Age ◽  
Predictive Value ◽  
Abdominal Circumference ◽  
Large For Gestational Age ◽  
Ultrasound Finding ◽  
Third Trimester ◽  
Fetal Biometry

Objective: To determine the accuracy of ultrasonography for predicting a large-for-gestational-age (LGA) newborn in women with gestational diabetes mellitus (GDM).Materials and Methods: Singleton pregnancy, diagnosed with GDM were recruited. They underwent ultrasonography at 32-36 weeks’ gestation for fetal biometry. Biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL). Estimated fetal weight (EFW) was derived from these 4 parameters by Hadlock formula. Delivery of an LGA newborn in women with the ultrasound finding of LGA fetus was the primary outcome.Results: Of 345 studied women, 107 (31%) had an LGA newborn. EFW of ≥ 90 th percentile at third trimester ultrasonography was found in 13 women, all of whom had an LGA newborn. It had a positive predictive value (PPV), specificity, sensitivity and negative predictive value (NPV) of 100%, 100%, 12.1% and 71.7% respectively to predict LGA at birth. Considering each fetal parameter individually, AC > 90 th percentile and HC > 90 th percentile had odds ratios (OR) with 95% confidence intervals of the newborn being LGA of 6.5 (3.3-12.8) and 2.0 (1.0-4.0) respectively while EFW > 85 th percentile had the highest OR of 9.3 (1.1-77.9). Lowering cutoff values of EFW to 80 th and 70 th percentile increased the sensitivity and NPV for prediction of LGA at birth while reducing the PPV and specificity slightly.Conclusion: EFW derived from the third trimester ultrasonography in GDM had high PPV and specificity with low to moderate sensitivity and NPV to predict an LGA newborn in GDM.

scholarly journals Exposure to Gestational Diabetes Is a Stronger Predictor of Dysmetabolic Traits in Children Than Size at Birth

2018 ◽  
Vol 104 (5) ◽  
pp. 1766-1776 ◽  
Author(s):  
Freja Bach Kampmann ◽  
Anne Cathrine Baun Thuesen ◽  
Line Hjort ◽  
Sjurdur Frodi Olsen ◽  
Sara Monteiro Pires ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Birth Cohort ◽  
Gestational Age ◽  
Metabolic Profile ◽  
Large For Gestational Age ◽  
Independent Effect ◽  
Birth Cohort Study ◽  
Childhood And Adolescence ◽  
Size At Birth ◽  
Cardiometabolic Traits

Abstract Context and Objective Being born small or large for gestational age and intrauterine exposure to gestational diabetes (GDM) increase the risk of type 2 diabetes in the offspring. However, the potential combined deleterious effects of size at birth and GDM exposure remains unknown. We examined the independent effect of size at birth and the influence of GDM exposure in utero on cardiometabolic traits, body composition, and puberty status in children. Design, Participants, and Methods The present study was a longitudinal birth cohort study. We used clinical data from 490 offspring of mothers with GDM and 527 control offspring aged 9 to 16 years, born singleton at term from the Danish National Birth Cohort with available birthweight data. Results We found no evidence of a U-shaped association between size at birth (expressed as birthweight, sex, and gestational age adjusted z-score) and cardiometabolic traits. Body size in childhood and adolescence reflected the size at birth but was not reflected in any metabolic outcome. No synergistic adverse effect of being born small or large for gestational age and exposure to GDM was shown. However, GDM was associated with an adverse metabolic profile and earlier onset of female puberty in childhood and adolescence independently of size at birth. Conclusion In childhood and adolescence, we found GDM was a stronger predictor of dysmetabolic traits than size at birth. The combination of being born small or large and exposed to GDM does not exacerbate the metabolic profile in the offspring.

scholarly journals Prediction of large‐for‐gestational‐age neonate by routine third‐trimester ultrasound

2019 ◽  
Vol 54 (3) ◽  
pp. 326-333 ◽  
Author(s):  
N. Khan ◽  
A. Ciobanu ◽  
T. Karampitsakos ◽  
R. Akolekar ◽  
K. H. Nicolaides
Keyword(s):  
Gestational Age ◽  
Large For Gestational Age ◽  
Third Trimester
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