Document Detail


Heterogeneity of fetal growth in type 1 diabetic pregnancy.
MedLine Citation:
PMID:  11431599     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the frequency of macrosomia in an homogeneous cohort of type 1 diabetic mothers and to analyze the influence of maternal factors and glycemic control on the incidence of fetal macrosomia. MATERIAL AND METHODS: Fifty-five consecutive type 1 diabetic first-pregnancies were prospectively studied. Macrosomia was defined by a ponderal index above the 90(th) percentile. Venous cord blood levels of insulin, C peptide and leptin were measured at delivery. The influence of HbA1c levels and other maternal variables on the occurrence of macrosomia and on the ponderal index was assessed using a stepwise regression logistic model. RESULTS: The mean (+/- SD) birth weight was 3482 (+/- 497) g at 37.4 +/- 1.0 weeks gestation. Macrosomia occurred in 29 cases (53.7%). Fetal insulin, C peptide and leptin levels were significantly higher in macrosomic than in non macrosomic infants. Maternal age, duration of diabetes, pregravid body mass index, parity, weight gain during pregnancy, presence of a microangiopathy, nephropathy, smoking habits, gestational hypertension or preeclampsia, and HbA1c levels throughout pregnancy did not differed between mothers of macrosomic and non macrosomic infants. In the stepwise analysis none of these covariates was explanatory of the ponderal index. CONCLUSIONS: The frequency of macrosomia remains very high in infants of type 1 diabetic mothers despite a reasonable degree of glycemic control. The variability of the fetal growth response to mild hyperglycemia prompts for the identification of other factors involved in the modulation of fetal growth.
Authors:
J Lepercq; P Taupin; D Dubois-Laforgue; L Duranteau; N Lahlou; C Boitard; P Landais; S Hauguel-De Mouzon; J Timsit
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diabetes & metabolism     Volume:  27     ISSN:  1262-3636     ISO Abbreviation:  Diabetes Metab.     Publication Date:  2001 Jun 
Date Detail:
Created Date:  2001-06-29     Completed Date:  2001-09-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9607599     Medline TA:  Diabetes Metab     Country:  France    
Other Details:
Languages:  eng     Pagination:  339-44     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Cochin-Saint Vincent-de-Paul Hospital, Paris. j.lepercq@svp.ap-hop-paris.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Birth Weight
Blood Glucose / analysis
C-Peptide / blood
Diabetes Mellitus, Type 1 / physiopathology*
Embryonic and Fetal Development*
Female
Fetal Macrosomia / blood,  epidemiology*
Gestational Age
Hemoglobin A, Glycosylated / analysis
Humans
Hypoglycemia / epidemiology
Infant, Newborn
Insulin / blood
Leptin / blood
Maternal Age
Placenta / anatomy & histology
Pregnancy
Pregnancy in Diabetics / physiopathology*
Prospective Studies
Reference Values
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/C-Peptide; 0/Hemoglobin A, Glycosylated; 0/Leptin; 11061-68-0/Insulin

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