Kamana Kc1, Sumisti Shakya, Hua Zhang. 1. Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China.
Abstract
BACKGROUND: Fetal macrosomia, defined as a birth weight ≥ 4,000 g, may affect 12% of newborns of normal women and 15-45% of newborns of women with gestational diabetes mellitus (GDM). The increased risk of macrosomia in GDM is mainly due to the increased insulin resistance of the mother. In GDM, a higher amount of blood glucose passes through the placenta into the fetal circulation. As a result, extra glucose in the fetus is stored as body fat causing macrosomia, which is also called 'large for gestational age'. This paper reviews studies that explored the impact of GDM and fetal macrosomia as well as macrosomia-related complications on birth outcomes and offers an evaluation of maternal and fetal health. SUMMARY: Fetal macrosomia is a common adverse infant outcome of GDM if unrecognized and untreated in time. For the infant, macrosomia increases the risk of shoulder dystocia, clavicle fractures and brachial plexus injury and increases the rate of admissions to the neonatal intensive care unit. For the mother, the risks associated with macrosomia are cesarean delivery, postpartum hemorrhage and vaginal lacerations. Infants of women with GDM are at an increased risk of becoming overweight or obese at a young age (during adolescence) and are more likely to develop type II diabetes later in life. Besides, the findings of several studies that epigenetic alterations of different genes of the fetus of a GDM mother in utero could result in the transgenerational transmission of GDM and type II diabetes are of concern.
BACKGROUND:Fetal macrosomia, defined as a birth weight ≥ 4,000 g, may affect 12% of newborns of normal women and 15-45% of newborns of women with gestational diabetes mellitus (GDM). The increased risk of macrosomia in GDM is mainly due to the increased insulin resistance of the mother. In GDM, a higher amount of blood glucose passes through the placenta into the fetal circulation. As a result, extra glucose in the fetus is stored as body fat causing macrosomia, which is also called 'large for gestational age'. This paper reviews studies that explored the impact of GDM and fetal macrosomia as well as macrosomia-related complications on birth outcomes and offers an evaluation of maternal and fetal health. SUMMARY:Fetal macrosomia is a common adverse infant outcome of GDM if unrecognized and untreated in time. For the infant, macrosomia increases the risk of shoulder dystocia, clavicle fractures and brachial plexus injury and increases the rate of admissions to the neonatal intensive care unit. For the mother, the risks associated with macrosomia are cesarean delivery, postpartum hemorrhage and vaginal lacerations. Infants of women with GDM are at an increased risk of becoming overweight or obese at a young age (during adolescence) and are more likely to develop type II diabetes later in life. Besides, the findings of several studies that epigenetic alterations of different genes of the fetus of a GDM mother in utero could result in the transgenerational transmission of GDM and type II diabetes are of concern.
Authors: Bao-Ying Feng; Yang Peng; Jun Liang; Li Wu; Qun-Jiao Jiang; Shun Liu; Xiao-Yun Zeng; Dong-Ping Huang; Xiao-Qiang Qiu; Han Li Journal: Curr Med Sci Date: 2021-04-20
Authors: Taylor M Etzel; Antonia M Calafat; Xiaoyun Ye; Aimin Chen; Bruce P Lanphear; David A Savitz; Kimberly Yolton; Joseph M Braun Journal: Environ Res Date: 2017-04-26 Impact factor: 6.498
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: Damaskini Valvi; Youssef Oulhote; Pal Weihe; Christine Dalgård; Kristian S Bjerve; Ulrike Steuerwald; Philippe Grandjean Journal: Environ Int Date: 2017-07-25 Impact factor: 9.621