Maternal Glycemia and Risk of Large-for-Gestational-Age Babies in a Population-Based Screening
| Autor: | A Peterfalvi, Adam G. Tabak, Eszter Madarász, Mika Kivimäki, Z Bosnyák, Gyula Tamás, Zsuzsa Kerényi |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Blood Glucose medicine.medical_specialty Urban Population Pregnancy Trimester Third Endocrinology Diabetes and Metabolism Birth weight Population Blood sugar Blood Pressure Gestational Age Pregnancy Diabetes mellitus Internal medicine Internal Medicine Birth Weight Body Size Humans Mass Screening Medicine Epidemiology/Health Services Research education Mass screening Original Research Advanced and Specialized Nursing Hungary education.field_of_study Glucose tolerance test medicine.diagnostic_test business.industry Obstetrics Infant Newborn Gestational age Glucose Tolerance Test medicine.disease Gestational diabetes Diabetes Gestational Parity Endocrinology Pregnancy Trimester Second Female business |
| Zdroj: | University of Helsinki Diabetes Care |
| ISSN: | 1935-5548 0149-5992 |
| DOI: | 10.2337/dc09-1088 |
| Popis: | OBJECTIVE Gestational diabetes is a risk factor for large-for-gestational-age (LGA) newborns, but many LGA babies are born to mothers with normal glucose tolerance. We aimed to clarify the association of maternal glycemia across the whole distribution with birth weight and risk of LGA births in mothers with normal glucose tolerance. RESEARCH DESIGN AND METHODS We undertook a population-based gestational diabetes screening in an urban area of Hungary in 2002–2005. All singleton pregnancies of mothers ≥18 years of age, without known diabetes or gestational diabetes (World Health Organization criteria) and data on a 75-g oral glucose tolerance test at 22–30 weeks of gestation, were included (n = 3,787, 78.9% of the target population). LGA was determined as birth weight greater than the 90th percentile using national sex- and gestational age–specific charts. RESULTS Mean ± SD maternal age was 30 ± 4 years, BMI was 22.6 ± 4.0 kg/m2, fasting blood glucose was 4.5 ± 0.5 mmol/l, and postload glucose was 5.5 ± 1.0 mmol/l. The mean birth weight was 3,450 ± 476 g at 39.2 ± 1.2 weeks of gestation. There was a U-shaped association of maternal fasting glucose with birth weight (Pcurve = 0.004) and risk of having an LGA baby (lowest values between 4 and 4.5 mmol/l, Pcurve = 0.0004) with little change after adjustments for clinical characteristics. The association of postload glucose with birth weight (P = 0.03) and the risk of an LGA baby (P = 0.09) was weaker and linear. CONCLUSIONS Both low and high fasting glucose values at 22–30 weeks of gestation are associated with increased risk of an LGA newborn. We suggest that the excess risk related to low glucose reflects the increased use of nutrients by LGA fetuses that also affects the mothers' fasting glucose. |
| Databáze: | OpenAIRE |
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