Serial fetal abdominal circumference measurements in predicting normal birth weight in gestational diabetes mellitus |
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| Affiliation: | 1. Dublin Diabetes in Pregnancy Centre, Mater Misericordiae University Hospital, Dublin 7, Ireland;2. Department of Obstetrics and Fetal Medicine, Coombe Women and Infants University Hospital, Dublin 8, Ireland;1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Institute of Women''s Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea;2. Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Republic of Korea;1. University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK;2. Birmingham Women''s NHS Foundation Trust, Birmingham, UK;1. Reproductive Medical Center, Department of Obstetrics and Gynaecology, Central South University, Changsha 410008, PR China;2. Hepatobiliary & Enteric Surgery Research Center, Xiangya Hospital, Central South University, Changsha 410008, PR China;1. Department of Obstetrics and Gynaecology, Oncology Unit, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey;2. Department of Medical Biology, Trakya University Medical Faculty, Edirne, Turkey;3. Department of Medical Genetics, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey;1. Surgical Gynecologic Oncology Unit, Gynecologic Department, Geneva University Hospital, Switzerland;2. Faculty of Medicine, University of Geneva, Switzerland;3. Geneva Cancer Registry, University of Geneva, Switzerland |
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| Abstract: | ObjectivesTo construct a clinical management matrix using serial fetal abdominal circumference measurements (ACMs) that will predict normal birth weight in pregnancies complicated by gestational diabetes (GDM) and reduce unnecessary ultrasound examination in women with GDM.Study designRetrospective cohort study of 144 women with GDM in a specialist obstetric-diabetes clinic. Women with GDM who delivered singleton infants were identified from a clinical register. Regression analysis was used to identify associations between serial ACMs, maternal parameters and normal birth weight (birth weight between the 10th and 90th percentiles). Predictive clinical models were designed with the aim of identifying normal birth weight infants with the lowest number of fetal ultrasound scans.ResultsCompared to mothers of large-for-gestational-age (LGA) infants, mothers of normal weight infants had lower fasting glucose measurements at diagnosis (5.9 mmol/l ± 1.0 vs. 6.6 mmol/l ± 0.7, p < 0.05), lower maternal weight at delivery (90 kg ± 17 vs. 96 kg ± 17, p < 0.05), and a lower rate of prior LGA infants (31% vs. 60%, p < 0.05). Maternal weight and a history of prior LGA delivery were identified as useful predictors of fetal birth weight in predictive models. Serial ACMs below the 50th, 75th and 90th percentiles could predict normal birth weight with 100%, 97% and 96% positive predictive value respectively when used in these risk factor based models. Two measurements sufficed in low-risk pregnancies.ConclusionSerial ACMs can predict normal birth weight in GDM. |
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| Keywords: | Fetal abdominal circumference Gestational diabetes Normal birth weight |
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