OBJECTIVE: To assess fetal growth profiles in an unselected group of pregnant women with either type-1 diabetes (DM1), type-2 diabetes (DM2) or gestational diabetes (GDM), with emphasis on intergroup differences and development of disproportionate fetal growth and macrosomia. METHODS: Second- and third-trimester longitudinal ultrasound measurements of fetal growth were made in 77 women with DM1, 68 women with DM2 and in 99 women with GDM. Altogether 897 ultrasound examinations were performed and 145 uncomplicated pregnancies with 843 ultrasound examinations were included as controls. Ultrasound data included head circumference (HC), abdominal circumference (AC), femur length (FL) and HC/AC ratio. RESULTS: The AC, but not HC and FL, evolved differently in diabetic pregnancies, with a smaller AC in early pregnancy and larger AC at term (significant for DM1 and DM2). The most striking differences were found for the HC/AC ratio, especially in DM1 pregnancies. HC/AC growth trajectories of both macrosomic and non-macrosomic fetuses differed from that of the controls, and the HC/AC ratio at term was lower in all diabetic subgroups except in non-macrosomic DM2 cases. CONCLUSION: We found altered (disproportionate) fetal growth in macrosomic and non-macrosomic fetuses of women with DM1, DM2 and GDM. This indicates that the abnormal intrauterine environment affects the majority of these infants. Growth profiles differed among these groups, the most prominent growth deviations being found in the fetuses of women with DM1. The latter was most probably caused by poor glucose control. In monitoring fetal growth in diabetic pregnancies the HC/AC ratio should be used to assess altered fetal growth.
OBJECTIVE: To assess fetal growth profiles in an unselected group of pregnant women with either type-1 diabetes (DM1), type-2 diabetes (DM2) or gestational diabetes (GDM), with emphasis on intergroup differences and development of disproportionate fetal growth and macrosomia. METHODS: Second- and third-trimester longitudinal ultrasound measurements of fetal growth were made in 77 women with DM1, 68 women with DM2 and in 99 women with GDM. Altogether 897 ultrasound examinations were performed and 145 uncomplicated pregnancies with 843 ultrasound examinations were included as controls. Ultrasound data included head circumference (HC), abdominal circumference (AC), femur length (FL) and HC/AC ratio. RESULTS: The AC, but not HC and FL, evolved differently in diabetic pregnancies, with a smaller AC in early pregnancy and larger AC at term (significant for DM1 and DM2). The most striking differences were found for the HC/AC ratio, especially in DM1 pregnancies. HC/AC growth trajectories of both macrosomic and non-macrosomic fetuses differed from that of the controls, and the HC/AC ratio at term was lower in all diabetic subgroups except in non-macrosomic DM2 cases. CONCLUSION: We found altered (disproportionate) fetal growth in macrosomic and non-macrosomic fetuses of women with DM1, DM2 and GDM. This indicates that the abnormal intrauterine environment affects the majority of these infants. Growth profiles differed among these groups, the most prominent growth deviations being found in the fetuses of women with DM1. The latter was most probably caused by poor glucose control. In monitoring fetal growth in diabetic pregnancies the HC/AC ratio should be used to assess altered fetal growth.
Authors: Mengying Li; Stefanie N Hinkle; Katherine L Grantz; Sungduk Kim; Jagteshwar Grewal; William A Grobman; Daniel W Skupski; Roger B Newman; Edward K Chien; Anthony Sciscione; Noelia Zork; Deborah A Wing; Michael Nageotte; Fasil Tekola-Ayele; Germaine M Buck Louis; Paul S Albert; Cuilin Zhang Journal: Lancet Diabetes Endocrinol Date: 2020-03-02 Impact factor: 32.069
Authors: Nurah M Hammoud; Harold W de Valk; Lenie van Rossem; Douwe H Biesma; Jan M Wit; Gerard H A Visser Journal: Pediatr Res Date: 2016-11-09 Impact factor: 3.756
Authors: Line Sletner; Anne Karen Jenum; Chittaranjan S Yajnik; Kjersti Mørkrid; Britt Nakstad; Odd Harald Rognerud-Jensen; Kåre I Birkeland; Siri Vangen Journal: PLoS One Date: 2017-03-02 Impact factor: 3.240
Authors: Nurah M Hammoud; Gerard H A Visser; Lenie van Rossem; Douwe H Biesma; Jan M Wit; Harold W de Valk Journal: Diabetologia Date: 2018-02-28 Impact factor: 10.122
Authors: Madelon L Geurtsen; Eef E L van Soest; Ellis Voerman; Eric A P Steegers; Vincent W V Jaddoe; Romy Gaillard Journal: Diabetologia Date: 2019-08-08 Impact factor: 10.122
Authors: Judith S Brand; Jane West; Derek Tuffnell; Philippa K Bird; John Wright; Kate Tilling; Debbie A Lawlor Journal: BMC Med Date: 2018-11-06 Impact factor: 8.775