Third-Trimester Maternal Glucose Levels From Diurnal Profiles in Nondiabetic Pregnancies

• Published in: Diabetes care Vol. 24; no. 8; pp. 1319 - 1323
• Main Authors: Parretti, Elena, Mecacci, Federico, Papini, Marta, Cioni, Riccardo, Carignani, Lucia, Mignosa, Marcella, La Torre, Pasquale, Mello, Giorgio
• Format: Journal Article
• Language: English
• Published: American Diabetes Association 01-08-2001
• Subjects: Blood sugar; Diabetes; Measurement; Physiological aspects; Pregnant women; United States
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/diacare.24.8.1319

Third-Trimester Maternal Glucose Levels From Diurnal Profiles in Nondiabetic Pregnancies
Correlation with sonographic parameters of fetal growth
Elena Parretti , MD ,
Federico Mecacci , MD ,
Marta Papini , MD ,
Riccardo Cioni , MD, MSC ,
Lucia Carignani , MD ,
Marcella Mignosa , MD ,
Pasquale La Torre , MD and
Giorgio Mello , MD
Second Obstetric and Gynecologic Clinic, Department of Gynecology, Perinatology and Human Reproduction, University of Florence,
Viale Morgagni 85, Florence I-50134, Italy
Abstract
OBJECTIVE —To assess the 24-h glucose levels in a group of nondiabetic, nonobese pregnant women and to verify the presence of correlations
between maternal glucose levels and sonographic parameters of fetal growth.
RESEARCH DESIGN AND METHODS —A total of 66 Caucasian nonobese pregnant women with normal glucose challenge tests (GCT) enrolled in the study; from this
population, we selected 51 women who delivered term (from 37 to 42 weeks completed) live-born infants without evidence of
congenital malformations. The women were requested to have three main meals and to perform daily glucose profiles fortnightly
from 28–38 weeks without modifying their lifestyle or following any dietary restriction. All subjects were taught how to monitor
their blood glucose by using a reflectance meter. Fetal biometry was evaluated by ultrasound scan according to standard methodology
at 22, 28, 32, and 36 weeks of pregnancy.
RESULTS —The overall daily mean glucose level during the third trimester was 74.7 ± 5.2 mg/dl. Daily mean glucose values increased
between 28 (71.9 ± 5.7 mg/dl) and 38 (78.3 ± 5.4 mg/dl) weeks of pregnancy. We found a significant positive correlation at
28 weeks between 1-h postprandial glucose values and fetal abdominal circumference (AC). At 32 weeks, we documented positive
correlations between fetal AC and maternal blood glucose levels 1 h after breakfast, 1 and 2 h after lunch, and 1 and 2 h
after dinner. At 36 weeks, there was a positive correlation between fetal AC and 1- and 2-h postprandial blood glucose levels.
In addition, there was a negative correlation between head-abdominal circumference ratio and 1-h postprandial blood glucose
values.
CONCLUSIONS —This longitudinal study first provides a contribution toward the definition of normoglycemia in nondiabetic, nonobese pregnant
women; moreover, it reveals significant correlations of postprandial blood glucose levels with the growth of insulin-sensitive
fetal tissues and, in particular, between 1-h postprandial blood glucose values and fetal AC.
AC, abdominal circumference
AGA, appropriate for gestational age
GCT, glucose challenge test
GDM, gestational diabetes mellitus
HC:AC, head-abdominal circumference ratio
LGA, large for gestational age
SGA, small for gestational age
Footnotes
Address correspondence and reprint requests to Giorgio Mello, MD, Via Masaccio 92, Florence, I-50100, Italy. E-mail address:
mellog{at}unifi.it .
Received for publication 26 December 2000 and accepted in revised form 5 April 2001.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.