Fetal biometry measurements in diabetic pregnant women and neonatal outcomes

In this study, we aimed to investigate how fetal head and abdominal circumferences are related to the incidence of neonatal complications in mothers with gestational diabetes mellitus (GDM) and pre-gestational diabetes mellitus (PGDM) compared to normal pregnancies.

We retrospectively analyzed data of expectant mothers with GDM, PGDM, and normal pregnancies who delivered singleton full-term infants (≥37 weeks) at a tertiary center from January 2013 to December 2022. Ultrasonography-measured fetal weight, fetal head circumference, fetal abdominal circumference, difference between head and abdominal circumference, and head-to-abdominal circumference ratio were assessed. Neonatal outcomes were evaluated based on the rates of admission to the neonatal intensive care unit, intubation, and hypoglycemia. Statistical analyses, including univariate and multivariate analyses, were performed using the SPSS software (IBM Corp., Armonk, NY, USA).

Among the 473 participants, 175 (37.0%) were mothers with diabetes (DM). A head-to-abdominal circumference ratio <0.95 and a difference of ≥2.5 cm were significantly associated with neonatal hypoglycemia in all mothers with DM, with statistical significance noted only in the PGDM group. No significant association was observed in normal pregnancies.

Our findings indicate that a head-to-abdominal circumference ratio <0.95 and a ≥2.5 cm difference in circumferences are associated with neonatal hypoglycemia in mothers with DM.