scholarly journals Early pregnancy hyperglycaemia as a significant predictor of large for gestational age neonates

2022 ◽  
Author(s):  
Imasha Upulini Jayasinghe ◽  
Iresha Sandamali Koralegedara ◽  
Suneth Buddhika Agampodi
Keyword(s):  
Diabetes Mellitus ◽  
Birth Weight ◽  
Early Pregnancy ◽  
Gestational Age ◽  
First Trimester ◽  
World Health ◽  
Large For Gestational Age ◽  
Evaluation Procedure ◽  
Who Criteria ◽  
In Pregnancy

Abstract Aims We aimed to determine the effect of early pregnancy hyperglycaemia on having a large for gestational age (LGA) neonate. Methods A prospective cohort study was conducted among pregnant women in their first trimester. One-step plasma glucose (PG) evaluation procedure was performed to assess gestational diabetes mellitus (GDM) and diabetes mellitus (DM) in pregnancy as defined by the World Health Organization (WHO) criteria with International Association of Diabetes in Pregnancy Study Group (IADPSG) thresholds. The main outcome studied was large for gestational age neonates (LGA). Results A total of 2,709 participants were recruited with a mean age of 28 years (SD = 5.4) and a median gestational age (GA) of eight weeks (interquartile range [IQR] = 2). The prevalence of GDM in first trimester (T1) was 15.0% (95% confidence interval [CI] = 13.7–16.4). Previously undiagnosed DM was detected among 2.5% of the participants. Out of 2,285 live births with a median delivery GA of 38 weeks (IQR = 3), 7.0% were LGA neonates. The cumulative incidence of LGA neonates in women with GDM and DM was 11.1 and 15.5 per 100 women, respectively. The relative risk of having an LGA neonate among women with DM and GDM was 2.30 (95% CI = 1.23–4.28) and 1.80 (95% CI = 1.27–2.53), respectively. The attributable risk percentage of a LGA neonate for hyperglycaemia was 15.01%. T1 fasting PG was significantly correlated with both neonatal birth weight and birth weight centile. Conclusions The proposed WHO criteria for hyperglycaemia in pregnancy are valid, even in T1, for predicting LGA neonates. The use of IADPSG threshold for Fasting PG, for risk assessment in early pregnancy in high-risk populations is recommended.

Antibiotic Use in Pregnancy, Abnormal Fetal Growth, and Development of Gestational Diabetes Mellitus

2018 ◽  
Vol 36 (03) ◽  
pp. 243-251 ◽  
Author(s):  
Janet Catov ◽  
Tiffany Deihl ◽  
Maisa Feghali ◽  
Christina Scifres ◽  
John Mission
Keyword(s):  
Diabetes Mellitus ◽  
Birth Weight ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Gestational Age ◽  
Academic Medical Center ◽  
Antibiotic Use ◽  
Large For Gestational Age ◽  
The Impact ◽  
In Pregnancy

Objective Antibiotics are commonly used in pregnancy. Prior studies have indicated that antibiotic use in pregnancy may affect birth weight, whereas data in nonpregnant individuals suggest that antibiotic exposure may increase diabetes risk. We evaluated the impact of antibiotic prescriptions during pregnancy on the prevalence of small for gestational age (SGA) and large for gestational age (LGA) birth weight and gestational diabetes mellitus (GDM). Study Design This retrospective cohort study of 12,551 women who delivered at a large academic medical center between 2012 and 2014 assessed the number and type of antibiotic prescriptions prior to GDM testing using the electronic medical record. SGA and LGA birth weight and GDM rates were compared among women who were or were not prescribed antibiotics. Results Overall, 3,991 (31.8%) of 12,551 patients received at least one antibiotic prescription. After covariate adjustment, no differences existed in risk of SGA (adjusted odds ratio [aOR]: 1; 95% confidence interval [CI]: 0.88–1.15; p = 0.94), LGA (aOR: 1; 95% CI: 0.86–1.17; p = 0.97), or GDM (aOR: 0.90; 95% CI: 0.72–1.13; p = 0.36) between women who were or were not prescribed antibiotics. Conclusion Antibiotic use does not affect the risk of SGA or LGA birth weight or GDM in pregnant women. These results provide reassurance regarding the use of antibiotics when clinically indicated in pregnancy.

scholarly journals Serum Microelements in Early Pregnancy and their Risk of Large-for-Gestational Age Birth Weight

Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 866 ◽  
Author(s):  
Małgorzata Lewandowska ◽  
Jan Lubiński
Keyword(s):  
Birth Weight ◽  
Early Pregnancy ◽  
Gestational Age ◽  
Preliminary Evidence ◽  
Large For Gestational Age ◽  
Female Fetus ◽  
Appropriate For Gestational Age ◽  
Nested Case Control ◽  
Relationship Of

Excessive birth weight has serious perinatal consequences, and it “programs” long-term health. Mother’s nutritional status can be an important element in fetal “programming”; microelements such as selenium (Se), zinc (Zn), copper (Cu), and iron (Fe) are involved in many metabolic processes. However, there are no studies assessing the relationship of the microelements in the peri-conceptual period with the risk of excessive birth weight. We performed a nested case control study of serum microelements’ levels in the 10–14th week of pregnancy and assessed the risk of large-for-gestational age (LGA) newborns using the data from a prospective cohort of pregnant women recruited in 2015–2016 in Poznań, Poland. Mothers delivering LGA newborns (n = 66) were examined with matched mothers delivering appropriate-for-gestational age (AGA) newborns (n = 264). Microelements’ levels were quantified using mass spectrometry. The odds ratios of LGA (and 95% confidence intervals) were calculated by multivariate logistic regression. In the whole group, women with the lowest quartile of Se had a 3 times higher LGA risk compared with women in the highest Se quartile (AOR = 3.00; p = 0.013). Importantly, the result was sustained in the subgroup of women with the normal pre-pregnancy BMI (AOR = 4.79; p = 0.033) and in women with a male fetus (AOR = 6.28; p = 0.004), but it was not sustained in women with a female fetus. There were no statistical associations between Zn, Cu, and Fe levels and LGA. Our study provides some preliminary evidence for the relationships between lower serum Se levels in early pregnancy and a higher risk of large-for-gestational age birth weight. Appropriate Se intake in the periconceptual period may be important for optimal fetal growth.

Factors influencing foetal growth in pregnancy complicated by diabetes

2017 ◽  
Vol 4 (6) ◽  
pp. 2136
Author(s):  
Sathish Kumar S. ◽  
Anandhi A. ◽  
Luke Ravi Chelliah ◽  
Karthick A. R.
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Pregnant Women ◽  
Fetal Growth ◽  
Gestational Age ◽  
Growth Pattern ◽  
Abdominal Circumference ◽  
Large For Gestational Age ◽  
Maternal Weight ◽  
In Pregnancy

Background: Gestational diabetes mellitus represents a metabolically altered fetal environment due to an increased maternal supply of carbohydrates. It leads to fetal hyperinsulinemia and stimulates insulin-sensitive tissue, predominantly of the abdomen, resulting in increased fetal growth and delivering large-for-gestational-age newborns. Implications of fetal hyperinsulinemia reach far beyond delivery. Children of mothers with diabetes in pregnancy are predisposed to develop obesity and glucose intolerance through a non-genetic “fuel-mediated” mechanism. The objective of the present study was to study the “fetal growth pattern at different periods of pregnancy complicated by diabetes” and to identify the factors that influence the fetal growth pattern in pregnancy complicated by diabetesMethods: 69 pregnant women with diabetes and 34 pregnant women without diabetes were included in the study by random sampling. Maternal parameters such as age, parity, height, weight at registration, and weight gain during pregnancy, BMI at the time of registration of pregnancy and at the time of delivery, detailed diabetic profile and management including meal plan, insulin administration and dosage were recorded. The fetuses were monitored for Biparietal diameter, abdomen circumference, femur length by 2 ultrasound examinations, one at 18-22 weeks and another at 28-32 weeks were performed. Soon after delivery, sex, gestational age, birth weight, length, head circumference and chest circumference of the newborn were recorded and infants were classified as LGA/SGA/AGA.Results: Maternal age, parity, BMI at the time of delivery and maternal weight gain had significant influence on the birth weight. The abdominal circumference of the fetus detected at 18-20 and 28-32 ultrasound scans had a very significant correlation with neonatal mean birth weight percentile. Conclusions: Not all babies born to diabetic mothers are macrosomic. SGA babies were not uncommon in pregnancies with diabetes especially in those who did not have significant micro vasculopathy. Maternal nutrition plays a significant key role in determining birth weight of babies even in pregnancies complicated by diabetes.

scholarly journals Alcohol consumption during pregnancy and perinatal results: a cohort study

2016 ◽  
Vol 134 (2) ◽  
pp. 146-152 ◽  
Author(s):  
Mariana Sbrana ◽  
Carlos Grandi ◽  
Murilo Brazan ◽  
Natacha Junquera ◽  
Marina Stevaux Nascimento ◽  
...  
Keyword(s):  
Cohort Study ◽  
Birth Weight ◽  
Preterm Birth ◽  
Alcohol Consumption ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Perinatal Outcomes ◽  
First Trimester ◽  
World Health

ABSTRACT CONTEXT AND OBJECTIVE: Alcohol consumption during pregnancy is a significant social problem that may be associated with adverse perinatal outcomes. The aim of this study was to describe alcohol consumption during pregnancy and to study its association with low birth weight, newborns small for gestational age and preterm birth. DESIGN AND SETTING: Nested cohort study, in the city of Ribeirão Preto, São Paulo, Brazil. METHODS: 1,370 women and their newborns were evaluated. A standardized questionnaire on health and lifestyle habits was applied to the mothers. Anthropometry was performed on the newborns. Alcohol consumption was defined as low, moderate or high, as defined by the World Health Organization. Adjusted logistic regression analysis was used. RESULTS: 23% of the women consumed alcohol during pregnancy. Consumption mainly occurred in the first trimester (14.8%) and decreased as the pregnancy progressed. The median alcohol intake was 3.89 g (interquartile range, IQR = 8 g) per day. In the unadjusted analysis, alcohol consumption increased the risk of low birth weight almost twofold (odds ratio, OR 1.91; 95% confidence interval, CI: 1.25-2.92). The risk was lower in the adjusted analysis (OR 1.62; 95% CI: 1.03-2.54). Alcohol consumption did not show associations with small for gestational age or preterm birth. There was greater risk of low birth weight and newborns small for gestational age and preterm birth among mothers who were both smokers and drinkers. CONCLUSIONS: The alcohol consumption rate during pregnancy was 23% and was independently associated with low birth weight, but there was no risk of newborns small for gestational age or preterm birth.

Abstract P174: Comparison of Groups With and Without Diabetes Mellitus and Preeclampsia in Pregnancy: A Retrospective Case-control Comparison

Hypertension ◽  
2015 ◽  
Vol 66 (suppl_1) ◽  
Author(s):  
Jessica L Wilson ◽  
Mary A Co ◽  
Syeda H Afroze ◽  
Ram R Kalagiri ◽  
Sarah Munir ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Age ◽  
Severe Disease ◽  
First Trimester ◽  
Case Control ◽  
Placental Development ◽  
Retrospective Case ◽  
Severe Condition ◽  
Diabetes Status ◽  
In Pregnancy

Objective: Preeclampsia (PreE) and diabetes mellitus (DM) in pregnancy share many risk factors and consequences. Thus, the interactions between these two disease-processes need to be further examined. We compared normal pregnancies to those complicated with preE, gestational diabetes (GDM), and/or pre-existing DM to assess the effect of DM on placental development and outcomes when this condition is complicated by preE. Methods: Chart reviews were performed in an IRB approved retrospective case-control design with pregnancies resulting in live born singletons. Total 178 subjects with preE with and without DM or GDM and live born singletons were selected from deliveries in 2008 through 2011 at Scott & White Memorial Hospital, Temple, Texas. These were compared to 443 without preE and with and without DM or GDM. Statistical analysis was performed using ANOVA and Duncan’s post-hoc test. Results: Patients who developed preE had higher systolic and diastolic pressures compared to groups without preE (p < 0.05). Patients with DM or GDM were older (p < 0.05). There was no difference among groups for gravidity (p = 0.21) with the average gravidity of 2.7 (1.8 SD) for 621 subjects having a range of 1 to 14 pregnancies. Patients with preE delivered earlier in pregnancy than those without preE regardless of diabetes status. However, those with preE and DM delivered earlier at 35.0 ± 0.4 weeks than the other two preE groups (p < 0.05), suggesting a more severe condition. Patients with DM who developed preE delivered smaller (p < 0.05) babies (correcting for gestational age at delivery) than those with DM without preE (1.00 ± 0.03 versus 1.16 ± 0.04, respectively). Development of GDM did not result in smaller babies for those pregnancies with preE (1.07 versus 1.09). Conclusions: The development of preE in those with pre-existing DM led to growth restriction and more severe disease as evidenced by lower birth weights corrected for gestational age and earlier gestational ages at delivery. These differences were not seen in GDM pregnancies. This observation supports the concept that elevated glucose levels during first trimester placental development may alter the placenta and lead to restriction later in pregnancy when a second stimulus triggers preE.

scholarly journals Five-Year Retrospective Evaluation of large for gestational age (LGA) infants who Birth Weight of Over 90% Percentile

2020 ◽  
Vol 2 (1) ◽  
pp. 1-4
Author(s):  
Hüseyin Altaş ◽  
Mehmet Sait İçen ◽  
Hıdır Budak ◽  
Rezan Bugday ◽  
Mehmet Şükrü Budak ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Birth Weight ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Cesarean Delivery ◽  
Gestational Age ◽  
Large For Gestational Age ◽  
Normal Delivery ◽  
Gynecology And Obstetrics ◽  
The Mean

Objective: The aim of this study is to evaluate the obstetric and neonatal outcomes of pregnant women delivering large for gestational age (LGA) infants. Material and Methods: A total of 399 pregnant women giving birth to LGA infants in the Gynecology and Obstetrics Department of Dicle University Medical Faculty Hospital between January 2014 and December 2018 were included in this retrospective study. Demographic features, pregnancy and infant data, delivery type (vaginal delivery/cesarean delivery), and patients’ indications for cesarean section were assessed. Results: The mean age of the patients was 32.34±6.63, their gravida was 5.16±2.65 and parity was 3.55±2.36. The mean gestational week was 37.12±2.840 weeks and the mean birth weight was 3922.46±643.546 g. Of all patients, diabetes was detected in 28.5%, polyhydramnios in 11.3%, placental invasion anomaly in 4%, and preeclampsia in 9%. While 83.7% (334) of the patients underwent cesarean section, the remaining 16.3% (65) underwent normal delivery. 3.25% (13) of the patients developed complications during delivery. The rate of fetal anomaly was 11.7% (47) in existing pregnancies while the rate of fetal death was 5.01% (20). Conclusion: A cesarean delivery was performed in the majority of pregnant women with a suspected LGA infant. This group of patients exhibited a very high rate of gestational diabetes mellitus and diabetes mellitus. Existing pregnancies constitute a specifical pregnancy population that should be taken into consideration regarding probable complications and problems with the infant.

Prediction of large-for-gestational age infants in relation to hyperglycemia in pregnancy – a comparison of statistical models

2021 ◽  
pp. 108975
Author(s):  
Kristen S. GIBBONS ◽  
Allan M.Z. CHANG ◽  
Ronald C.W. MA ◽  
Wing Hung TAM ◽  
Patrick M. CATALANO ◽  
...  
Keyword(s):  
Gestational Age ◽  
Statistical Models ◽  
Large For Gestational Age ◽  
In Pregnancy
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