A1 Refereed original research article in a scientific journal
Detection of pregnancies with high risk of fetal macrosomia among women with gestational diabetes mellitus
Authors: Suhonen L, Hiilesmaa V, Kaaja R, Teramo K
Publication year: 2008
Journal: Acta Obstetricia et Gynecologica Scandinavica
Journal name in source: Acta obstetricia et gynecologica Scandinavica
Journal acronym: Acta Obstet Gynecol Scand
Volume: 87
Issue: 9
First page : 940
Last page: 5
Number of pages: 6
ISSN: 0001-6349
eISSN: 1600-0412
DOI: https://doi.org/10.1080/00016340802334377
Abstract
To compare the frequency of fetal macrosomia and Erb's palsy in two groups of women with gestational diabetes mellitus (GDM) and in healthy controls.\nRetrospective clinical study of women with GDM.\nPregnant women in Greater Helsinki area.\nNine hundred and five pregnancies and newborn infants of women with GDM and 805 non-diabetic controls.\nGDM was diagnosed by a 2-hour oral glucose tolerance test (OGTT) among women with risk factors for GDM. The treatment of GDM was resolved by a 24-hour glucose profile obtained after 2 or 3 abnormal glucose values in the OGTT. Patients with a history of insulin-treated GDM in a previous pregnancy and those with a fasting glucose over 6 mmol/l underwent a 24-h glucose profile directly without a preceding OGTT.\nFetal macrosomia, defined as a birth weight (adjusted for sex and gestational age) of >2.0 SD above the mean of a Finnish standard population. Erb's palsy.\n385 women (42.5%) were treated with insulin and diet and 520 (57.5%) with diet only. Macrosomia occurred more often in the insulin-treated group (18.2%, p<0.001) compared with the diet-treated group (4.4%) and the controls (2.2%). The rate of Erb's palsy was 2.7% in the insulin-treated group, 2.4% in the diet-treated group, compared with 0.3% in the controls (p<0.001).\nThe 24-hour glucose profile performed after the diagnosis of GDM clearly distinguishes between low-risk (diet-treated) and high-risk (insulin-treated) for fetal macrosomia in GDM pregnancies.\nOBJECTIVE\nDESIGN\nSETTING\nPOPULATION\nMETHODS\nMAIN OUTCOME MEASURES\nRESULTS\nCONCLUSION
To compare the frequency of fetal macrosomia and Erb's palsy in two groups of women with gestational diabetes mellitus (GDM) and in healthy controls.\nRetrospective clinical study of women with GDM.\nPregnant women in Greater Helsinki area.\nNine hundred and five pregnancies and newborn infants of women with GDM and 805 non-diabetic controls.\nGDM was diagnosed by a 2-hour oral glucose tolerance test (OGTT) among women with risk factors for GDM. The treatment of GDM was resolved by a 24-hour glucose profile obtained after 2 or 3 abnormal glucose values in the OGTT. Patients with a history of insulin-treated GDM in a previous pregnancy and those with a fasting glucose over 6 mmol/l underwent a 24-h glucose profile directly without a preceding OGTT.\nFetal macrosomia, defined as a birth weight (adjusted for sex and gestational age) of >2.0 SD above the mean of a Finnish standard population. Erb's palsy.\n385 women (42.5%) were treated with insulin and diet and 520 (57.5%) with diet only. Macrosomia occurred more often in the insulin-treated group (18.2%, p<0.001) compared with the diet-treated group (4.4%) and the controls (2.2%). The rate of Erb's palsy was 2.7% in the insulin-treated group, 2.4% in the diet-treated group, compared with 0.3% in the controls (p<0.001).\nThe 24-hour glucose profile performed after the diagnosis of GDM clearly distinguishes between low-risk (diet-treated) and high-risk (insulin-treated) for fetal macrosomia in GDM pregnancies.\nOBJECTIVE\nDESIGN\nSETTING\nPOPULATION\nMETHODS\nMAIN OUTCOME MEASURES\nRESULTS\nCONCLUSION