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Diabetes Metab. 2014 Feb;40(1):43-8. doi: 10.1016/j.diabet.2013.01.008. Epub 2013 Sep 17.

Factors predictive of macrosomia in pregnancies with a positive oral glucose challenge test: importance of fasting plasma glucose.

Author information

1
Service de gynécologie-obstétrique, hôpital Louis-Mourier, hôpitaux universitaires, Paris Nord Val-de-Seine et université Paris-Diderot, HUPNVS, AP-HP, 178, rue des Renouillers, 92701 Colombes cedex, France.
2
Unité de recherche clinique en économie de la santé d'Île-de-France, 228, rue du Faubourg-Saint-Honoré, 75010 Paris, France.
3
Service de gynécologie-obstétrique, hôpital Louis-Mourier, hôpitaux universitaires, Paris Nord Val-de-Seine et université Paris-Diderot, HUPNVS, AP-HP, 178, rue des Renouillers, 92701 Colombes cedex, France. Electronic address: laurent.mandelbrot@lmr.aphp.fr.

Abstract

AIM:

The study aimed to determine the factors associated with fetal macrosomia following a positive oral glucose challenge test (OGCT).

METHODS:

In this retrospective single-centre study of 1268 pregnancies with positive 50-g OGCTs (plasma glucose≥130mg/dL, or 7.2mmol/L), gestational diabetes mellitus (GDM) was defined as fasting plasma glucose (FPG)≥95mg/dL (5.3mmol/L) and/or postprandial glucose (PPG)≥120mg/dL (6.7mmol/L).

RESULTS:

In GDM pregnancies, the odds ratios adjusted for confounders (age, BMI, ethnicity, parity and weight gain) were 2.02 for macrosomia (Z score≥1.28) and 2.62 for severe macrosomia (Z score≥1.88). For each 10-mg/dL increase in FPG, the mean birth-weight increase was 60g. Macrosomia risk did not differ between GDM patients with normal FPG (<95mg/dL, or 5.3mmol/L) and non-diabetics, but increased significantly in cases of FPG≥95mg/dL and regardless of the level of PPG.

CONCLUSION:

In our study population, birth-weight and macrosomia risk were strongly correlated with FPG, suggesting that it is a simple and efficient marker for the risk of macrosomia.

KEYWORDS:

Gestational diabetes mellitus; Macrosomia; Pregnancy; Screening

PMID:
24051249
DOI:
10.1016/j.diabet.2013.01.008
[Indexed for MEDLINE]
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