Ultrasonographic assessment of early fetal growth in insulin-treated diabetic pregnancies

Early fetal growth aberrations have been suggested in diabetic gestations. To characterize such aberrations sonographically, longitudinal crown-rump length measurements were made in a group of 20 control and 20 diabetic pregnancies. The study evaluated growth between 40 and 100 days of amenorrhea. The best-fit curve of growth as a function of gestational age was that of a nonlinear polynomial regression curve for both the control and the diabetic groups. The correlation coefficients were 0.997 and 0.887 for the control and diabetic groups, respectively; the standard error of the estimate was 0.054 and 0.19, respectively. A log10 linear transformation was performed successfully on each curve. Comparison of the slopes and the intercepts of the transformed control and diabetic curves revealed no significant differences. To evaluate the possibility of a transient fetal growth delay, interval growths and interval growth velocities were compared between groups. No significant differences were observed. The control and diabetic groups' mean (+/- SD) growth velocities were 0.043 +/- 0.023 and 0.040 +/- 0.022 mm/day/mm total, respectively (p = NS). The growth of two anomalous fetuses in the diabetic group was studied individually. Their growth characteristics could not be distinguished from the control fetuses' growth profiles. The present study fails to confirm the presence of early fetal growth delay in diabetic pregnancies. Moreover, the data suggest that the fetuses' early growth in the mother with poorly controlled diabetes is similar to that of control fetuses.