Increased abdominal circumference as predictor of macrosomia without evidence of adverse obstetrical or neonatal outcomes

The objectives of this study were to (a) assess the utility of fetal anthropometric variables to predict the most relevant adverse neonatal outcomes in a treated population with gestational diabetes mellitus (GDM) beyond the known impact of maternal anthropometric and metabolic parameters and (b) to identify the most important fetal predictors. A total of 189 patients with GDM were included. The fetal predictors included sonographically assessed fetal weight centile (FWC), FWC > 90% and <10%, and fetal abdominal circumference centile (FACC), FACC > 90% and < 10%, at 29 0/7 to 35 6/7 weeks. Neonatal outcomes comprising neonatal weight centile (NWC), large and small for gestational age (LGA, SGA), hypoglycemia, prematurity, hospitalization for neonatal complication, and (emergency) cesarean section were evaluated. Regression analyses were conducted. Fetal variables predicted anthropometric neonatal outcomes, prematurity, cesarean section and emergency cesarean section. These associations were independent of maternal anthropometric and metabolic predictors, with the exception of cesarean section. FWC was the most significant predictor for NWC, LGA and SGA, while FACC was the most significant predictor for prematurity and FACC > 90% for emergency cesarean section. In women with GDM, third-trimester fetal anthropometric parameters have an important role in predicting adverse neonatal outcomes beyond the impact of maternal predictors.

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Application of ATR-FTIR Spectroscopy and Decreased Proteins As Parameter of Negative Neonatal Outcomes in Women With Gestational Diabetes Mellitus

10.21203/rs.3.rs-152745/v1 ◽

2021 ◽

Author(s):

Emanuelly Bernardes-Oliveira ◽

Daniel Lucas Dantas de Freitas ◽

Ricardo Ney Cobucci ◽

Maria da Conceição Mesquita Cornetta ◽

Juliana Dantas de Araújo Santos Camargo ◽

...

Keyword(s):

Gestational Diabetes ◽

Pregnant Women ◽

Attenuated Total Reflection ◽

Neonatal Outcomes ◽

Abdominal Circumference ◽

Linear Discriminant ◽

Low Protein ◽

Lower Protein ◽

Protein Density ◽

First Time

Abstract In this study, we found for the first time that macrosomal newborns were associated with lower protein density when mothers with GDM were analyzed by infrared ATR-FTIR (Attenuated Total Reflection Fourier Transform) spectroscopy, and the Genetic Algorithm (GA) mathematical model associated with Linear Discriminant Analysis (LDA). This is a case-control study, comprised of a total of 49 newborns from mothers with GDM compared with 45 newborns from mothers without GDM. The evaluated neonatal outcomes were: type of delivery, prematurity, weight in relation to gestational age, apgar, macrosomia, and head/chest perimeter. Furthermore, we correlated the presence of these neonatal adverse effects with the density of proteins in GDM. The neonatal outcomes observed in newborns of mothers with GDM showed prematurity (p = 0.018), minimum head circumference (p = 0.027), abdominal circumference (p <0.01) and macrosomia (p <0.01) when compared to newborns of mothers without GDM. Prematurity and macrosomia occurred with greater significance among pregnant women diagnosed with gestational diabetes (p <0.05). There was a correlation between macrosomal newborns and low protein density confirmed by ATR-FTIR (GA-LDA) in diabetic pregnant women. On the other hand, macrosomal newborns of mothers with GDM were correlated with women who showed lower density of protein when analyzed by ATR-FTIR (GA-LDA). In this study, we observed that macrosomia was associated with low protein density of a mother with GDM. The approach described here, can be useful for the identification and exploration of macrosomia inunder various pathophysiological conditions of maternal GDM.

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