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Risk factors associated with altered fetal growth in patients with pregestational diabetes mellitus

Eriko Kanda1, Yoshio Matsuda, Yasuo Makino

  • 1Department of Obstetrics and Gynecology, Tokyo Women's Medical University, Tokyo, Japan. eeyore181479@yahoo.co.jp

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|November 11, 2011
PubMed

Insights

In pregestational diabetes mellitus (DM), high hemoglobin A1C (HbA1C) levels before delivery are linked to both small-for-gestational-age (SGA) and large-for-gestational-age (LGA) infants. Tight glycemic control may negatively impact fetal growth, particularly with retinopathy.

Area of Science:

  • Obstetrics and Gynecology
  • Endocrinology
  • Perinatology

Background:

  • Pregestational diabetes mellitus (DM) poses risks for abnormal fetal growth.
  • Understanding risk factors for small-for-gestational-age (SGA) and large-for-gestational-age (LGA) infants is crucial for improved perinatal outcomes.

Purpose of the Study:

  • To identify risk factors associated with abnormal fetal growth, specifically SGA and LGA, in pregnancies complicated by pregestational DM.

Main Methods:

  • A retrospective study involving 336 patients with pregestational DM.
  • Infants were classified as SGA (<10th percentile) or LGA (>90th percentile) based on birth weight.
  • Logistic regression analysis was employed to determine risk factors for SGA and LGA.

Main Results:

  • Retinopathy and pre-delivery hemoglobin A1C (HbA1C) were significant risk factors for SGA infants.
  • Primiparity and pre-delivery HbA1C were significant risk factors for LGA infants.
  • Increased HbA1C levels were associated with both SGA and LGA outcomes.

Conclusions:

  • Pre-delivery HbA1C levels significantly influence fetal growth, contributing to both SGA and LGA.
  • Intensive glycemic control in pregestational DM may adversely affect fetal development, especially when retinopathy is present.
  • These findings highlight the complex relationship between glycemic control and fetal growth in diabetic pregnancies.
Abstract

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