In:
BMC Pregnancy and Childbirth, Springer Science and Business Media LLC, Vol. 22, No. 1 ( 2022-12)
Abstract:
Third trimester fetal anthropometric parameters are known to predict neonatal complications. A better understanding of predictors of adverse fetal parameters might help to personalize the use and frequency of fetal ultrasound. The objectives of this study were: (a) to evaluate the utility of maternal sociodemographic, anthropometric and metabolic predictors to predict 3 rd trimester fetal anthropometric parameters in women with gestational diabetes mellitus (GDM), (b) to assess whether the impact of these maternal predictors is fetal sex-dependent, and (c) to provide a risk stratification for markers of fetal overgrowth (fetal weight centile (FWC) and fetal abdominal circumference centile (FACC) depending on prepregnancy BMI and gestational weight gain (GWG) until the 1 st GDM visit. Methods This prospective study included 189 women with GDM. Maternal predictors were age, ethnicity, prepregnancy BMI, GWG and excessive weight gain until the 1 st GDM visit, fasting, 1-hour and 2-hour blood glucose oral glucose tolerance test values, HbA1c at the 1 st visit and medical treatment requirement. Fetal outcomes included FWC, FWC 〉 90% and 〈 10%, FACC, FACC 〉 90% and 〈 10%, at 29 0/7 to 35 6/7 weeks of gestational age. We performed univariate and multivariate regression analyses and probability analyses. Results In multivariate analyses, prepregnancy BMI was associated with FWC, FWC 〉 90% and FACC. GWG until the 1 st GDM visit was associated with FWC, FACC and FACC 〉 90% (all p ≤ 0.045) . Other maternal parameters were not significantly associated with fetal anthropometry in multivariate analyses (all p ≥ 0.054) . In female fetuses, only GWG was associated with FACC ( p= 0.044 ). However, in male fetuses, prepregnancy BMI was associated with FWC, FWC 〉 90% and FACC and GWG with FWC in multivariate analyses (all p ≤ 0.030). In women with a prepregnancy BMI of ≥ 25 kg/m 2 and a GWG until the 1 st GDM visit ≥ 10.3 kg (mean GWG), the risk for FWC 〉 90% and FACC 〉 90% was 5.3 and 4 times higher than in their counterparts. Conclusions A personalized fetal ultrasound surveillance guided by fetal sex, prepregnancy BMI and GWG may be beneficial in reducing adverse fetal and neonatal outcomes.
Type of Medium:
Online Resource
ISSN:
1471-2393
DOI:
10.1186/s12884-022-04767-z
Language:
English
Publisher:
Springer Science and Business Media LLC
Publication Date:
2022
detail.hit.zdb_id:
2059869-5
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