[Predictive factors of macrosomia in diabetic pregnancies]

The authors carried out a retrospective analysis of 105 cases of pregnant diabetic patients in order to identify the women facing a high risk of a macrosomal birth. This group, which included 84 cases of diabetes of pregnancy and 21 cases of diabetes present before pregnancy, had an incidence of macrosomia of 46.6%. The patients were divided into 2 sub-groups: PM, which consisted of 49 diabetic patients with a macrosomal foetus and PN, consisting of 56 patients who delivered a foetus of normal weight. There was a significant correlation between the equilibrium of diabetes and the birth weight. However, there was a macrosomal rate of 35% in well-equilibrated patients. Comparison of the maternal characteristics did not reveal any significant difference between the two groups with regard to age, parity, history of macrosomia or weight gain during pregnancy. In contrast, the incidence of maternal obesity was significantly higher in the PM group. In addition, the induced hyperglycaemia values by oral route were higher in the mothers of macrosomal foetuses. The authors therefore think that obesity in diabetic pregnancy and orally-induced hyperglycaemia in diabetes of pregnancy provide an early test for macrosomia and make it possible to envisage prophylactic treatment.