H Legardeur1, G Girard1, N Journy2, V Ressencourt1, I Durand-Zaleski2, L Mandelbrot3. 1. Service de gynécologie-obstétrique, hôpital Louis-Mourier, hôpitaux universitaires, Paris Nord Val-de-Seine et université Paris-Diderot, HUPNVS, AP-HP, 178, rue des Renouillers, 92701 Colombes cedex, France. 2. Unité de recherche clinique en économie de la santé d'Île-de-France, 228, rue du Faubourg-Saint-Honoré, 75010 Paris, France. 3. Service de gynécologie-obstétrique, hôpital Louis-Mourier, hôpitaux universitaires, Paris Nord Val-de-Seine et université Paris-Diderot, HUPNVS, AP-HP, 178, rue des Renouillers, 92701 Colombes cedex, France. Electronic address: laurent.mandelbrot@lmr.aphp.fr.
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≥130mg/dL, or 7.2mmol/L), gestational diabetes mellitus (GDM) was defined as fasting plasma glucose (FPG)≥95mg/dL (5.3mmol/L) and/or postprandial glucose (PPG)≥120mg/dL (6.7mmol/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 60g. Macrosomia risk did not differ between GDM patients with normal FPG (<95mg/dL, or 5.3mmol/L) and non-diabetics, but increased significantly in cases of FPG≥95mg/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.
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≥130mg/dL, or 7.2mmol/L), gestational diabetes mellitus (GDM) was defined as fasting plasma glucose (FPG)≥95mg/dL (5.3mmol/L) and/or postprandial glucose (PPG)≥120mg/dL (6.7mmol/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 60g. Macrosomia risk did not differ between GDM patients with normal FPG (<95mg/dL, or 5.3mmol/L) and non-diabetics, but increased significantly in cases of FPG≥95mg/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.