Factors predictive of macrosomia in pregnancies with a positive oral glucose challenge test: Importance of fasting plasma glucose

Abstract Aim The study aimed to determine the factors associated with fetal macrosomia following a positive oral glucose challenge test (OGCT). Methods In this retrospective single-centre study of 1268 pregnancies with positive 50-g OGCTs (plasma glucose ≥ 130 mg/dL, or 7.2 mmol/L), gestational diab...

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Published in:	Diabetes & metabolism Vol. 40; no. 1; pp. 43 - 48
Main Authors:	Legardeur, H, Girard, G, Journy, N, Ressencourt, V, Durand-Zaleski, I, Mandelbrot, L
Format:	Journal Article
Language:	English
Published:	Paris Elsevier Masson SAS 01-02-2014 Masson Elsevier Masson
Subjects:	Adult Biological and medical sciences Biomarkers - blood Blood Glucose - metabolism Body Mass Index Diabetes, Gestational - blood Diabetes, Gestational - diagnosis Diabetes. Impaired glucose tolerance Diseases of mother, fetus and pregnancy Endocrine pancreas. Apud cells (diseases) Endocrinology & Metabolism Endocrinopathies Fasting Female Fetal Macrosomia - blood Fetal Macrosomia - diagnosis France Gestational diabetes mellitus Glucose Tolerance Test Gynecology. Andrology. Obstetrics Humans Infant, Newborn Internal Medicine Life Sciences Macrosomia Medical sciences Odds Ratio Parity Practice Guidelines as Topic Predictive Value of Tests Pregnancy Pregnancy. Fetus. Placenta Retrospective Studies Santé publique et épidémiologie Screening Weight Gain France Pregnancy Gestational diabetes mellitus Screening Macrosomia Fetal diseases Fasting Pregnancy disorders Malformation Gestational diabetes Glucose Predictive factor Gestational diabetes mellitus Macrosomia Screening Pregnancy
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Summary:	Abstract Aim The study aimed to determine the factors associated with fetal macrosomia following a positive oral glucose challenge test (OGCT). Methods In this retrospective single-centre study of 1268 pregnancies with positive 50-g OGCTs (plasma glucose ≥ 130 mg/dL, or 7.2 mmol/L), gestational diabetes mellitus (GDM) was defined as fasting plasma glucose (FPG) ≥ 95 mg/dL (5.3 mmol/L) and/or postprandial glucose (PPG) ≥ 120 mg/dL (6.7 mmol/L). Results In GDM pregnancies, the odds ratios adjusted for confounders (age, BMI, ethnicity, parity and weight gain) were 2.02 for macrosomia (Z score ≥ 1.28) and 2.62 for severe macrosomia (Z score ≥ 1.88). For each 10-mg/dL increase in FPG, the mean birth–weight increase was 60 g. Macrosomia risk did not differ between GDM patients with normal FPG (< 95 mg/dL, or 5.3 mmol/L) and non-diabetics, but increased significantly in cases of FPG ≥ 95 mg/dL and regardless of the level of PPG. Conclusion In our study population, birth–weight and macrosomia risk were strongly correlated with FPG, suggesting that it is a simple and efficient marker for the risk of macrosomia.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1262-3636 1878-1780
DOI:	10.1016/j.diabet.2013.01.008