Risk of macrosomia remains glucose-dependent in a cohort of women with pregestational type 1 diabetes and good glycemic control
| Autor: | Alicja Hebda-Szydło, Przemysław Witek, Izabela Janas, Maciej T. Malecki, Elżbieta Kozek, Barbara Katra, Jan Skupien, Katarzyna Cyganek, Iwona Trznadel-Morawska |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Blood Glucose medicine.medical_specialty endocrine system diseases Endocrinology Diabetes and Metabolism Birth weight Pregnancy in Diabetics 030209 endocrinology & metabolism Macrosomia Fetal Macrosomia 03 medical and health sciences Young Adult 0302 clinical medicine Endocrinology Pregnancy Risk Factors Diabetes mellitus medicine Birth Weight Humans 030212 general & internal medicine Glycemic Retrospective Studies Type 1 diabetes Obstetrics business.industry Infant Newborn nutritional and metabolic diseases medicine.disease Surgery Diabetes Mellitus Type 1 Quartile Cohort Gestation Female Original Article Glycated hemoglobin A1c business |
| Zdroj: | Endocrine |
| Popis: | Macrosomia risk remains high in type 1 diabetes (T1DM) complicated pregnancies. A linear relationship between macrosomia risk and glycated hemoglobin A1c (HbA1c) was described; however, low range of HbA1c has not been studied. We aimed to identify risk factors and examine the impact of HbA1c on the occurrence of macrosomia in newborns of T1DM women from a cohort with good glycemic control. In this observational retrospective one-center study we analyzed records of 510 consecutive T1DM pregnancies (1998–2012). The analyzed group consisted of 375 term singleton pregnancies. We used multiple regression models to examine the impact of HbA1c and self-monitored glucose in each trimester on the risk of macrosomia and birth weight. The median age of T1DM women was 28 years, median T1DM duration—11 years, median pregestational BMI—23.3 kg/m2. Median birth weight reached 3520 g (1st and 3rd quartiles 3150 and 3960, respectively) at median 39 weeks of gestation. There were 85 (22.7 %) macrosomic (>4000 g) newborns. Median HbA1c levels in the 1st, 2nd, and 3rd trimester were 6.4, 5.7, and 5.6 %. Third trimester HbA1c, mean fasting self-monitored glucose and maternal age were independent predictors of birth weight and macrosomia. There was a linear relationship between 3rd trimester HbA1c and macrosomia risk in HbA1c range from 4.5 to 7.0 %. Macrosomia in children of T1DM mothers was common despite excellent metabolic control. Glycemia during the 3rd trimester was predominantly responsible for this condition. |
| Databáze: | OpenAIRE |
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