Semiquantitative Assessment of Amniotic Fluid Among Individuals With and Without Diabetes Mellitus

• Published in: Journal of ultrasound in medicine Vol. 41; no. 2; pp. 447 - 455
• Main Authors: Bicocca, Matthew J., Qureshey, Emma J., Chauhan, Suneet P., Hernandez‐Andrade, Edgar, Sibai, Baha M., Nowlen, Carol, Stafford, Irene
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01-02-2022
• Subjects: Amniotic Fluid - diagnostic imaging; amniotic fluid index; deepest vertical pocket; diabetes; Diabetes, Gestational; Female; Humans; Infant; oligohydramnios; Oligohydramnios - diagnostic imaging; Oligohydramnios - epidemiology; polyhydramnios; Polyhydramnios - diagnostic imaging; Polyhydramnios - epidemiology; Pregnancy; Retrospective Studies; Ultrasonography, Prenatal; polyhydramnios; amniotic fluid index; diabetes; deepest vertical pocket; oligohydramnios
• ISSN: 0278-4297; 1550-9613
• DOI: 10.1002/jum.15725

Objective
To compare the rate and severity of abnormal amniotic fluid volumes (oligohydramnios or polyhydramnios), as well as the distribution of amniotic fluid levels, in pregnancies with and without diabetes.
Methods
We performed a retrospective cohort study of singleton nonanomalous pregnancies receiving an ultrasound examination (USE) in the third trimester. Pregnancies were categorized into those with and without diabetes and subcategorized by diabetes type. The primary outcomes were oligohydramnios or polyhydramnios. Polyhydramnios was also examined by severity. The association between maternal diabetes status and oligohydramnios or polyhydramnios was assessed using logistic regression. In addition, we computed gestational age‐specific amniotic fluid index (AFI) and deepest vertical pocket (DVP) centiles for pregnancies with and without diabetes.
Results
There were 60,226 USEs from 26,651 pregnancies that met inclusion criteria. There were 3992 (15.0%) pregnancies with diabetes and 22,659 (85.0%) without diabetes. Using AFI, the rate of polyhydramnios was 10.5 versus 3.8% (odds ratio [OR] 2.95; 95% confidence interval [CI] 2.62–3.32) for pregnancies with versus without diabetes, respectively; using DVP, the rate of polyhydramnios was 13.9 versus 5.4% (OR 2.84; 95% CI 2.56–3.15). Rates of oligohydramnios were also increased in pregnancies with diabetes (3.3 versus 2.6%; OR 1.26; 95% CI 1.04–1.52). The AFI and DVP were significantly higher in the cohort with diabetes between 28 and 36 weeks.
Conclusion
Within our study population, pregnancies with diabetes had increased rates of oligohydramnios and polyhydramnios as well as increased gestational age‐specific amniotic fluid volumes between 28 and 36 weeks. A higher prevalence of polyhydramnios was observed using DVP as compared to AFI; nevertheless, associations were similar using either method.