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Perinatal outcome in large-for-gestational-age infants. Is it influenced by gestational impaired glucose tolerance?

Terence T Lao1, Kar-Yin Wong

  • 1Department of Obstetrics and Gynaecology, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, P.R.C. laotth@hkucc.hku.hk

The Journal of Reproductive Medicine
|July 3, 2002
PubMed

Insights

Maternal impaired glucose tolerance (IGT) increases risks for newborns, even with diet management. This condition is linked to higher rates of serious infant complications, regardless of birth size.

Area of Science:

  • Obstetrics and Gynecology
  • Neonatology
  • Endocrinology

Background:

  • Impaired glucose tolerance (IGT) is defined by specific oral glucose tolerance test results.
  • Large-for-gestational age (LGA) infants are at increased risk for perinatal complications.

Purpose of the Study:

  • To investigate the association between maternal IGT and perinatal outcomes in LGA infants.
  • To determine if IGT independently affects infant morbidity beyond its influence on fetal growth.

Main Methods:

  • Retrospective analysis of 461 LGA newborns from singleton pregnancies.
  • Comparison of perinatal outcomes between nondiabetic pregnancies (n=382) and diet-treated IGT pregnancies (n=79).

Main Results:

  • The IGT group showed higher maternal age, prepregnancy weight, and BMI.
  • Despite similar infant size and gestational age, the IGT group had increased incidence of Erb's palsy, meconium aspiration syndrome, phototherapy, sepsis, and shoulder dystocia.
  • Adjusted analyses confirmed these associations, independent of confounding factors.

Conclusions:

  • Maternal IGT is associated with significantly increased perinatal morbidity in LGA infants.
  • This increased morbidity occurs independently of the effect of IGT on fetal size.
  • Dietary management of IGT may not fully mitigate these risks.
Abstract

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