Factors predictive of macrosomia in pregnancies with a positive oral glucose challenge test: importance of fasting plasma glucose.

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.

• Authors: H Legardeur, G Girard, N Journy, V Ressencourt, I Durand-Zaleski, L Mandelbrot
• Journal: Diabetes & metabolism (Diabetes Metab) Vol. 40 Issue 1 Pg. 43-48 (Feb 2014) ISSN: 1878-1780 [Electronic] France
• PMID: 24051249 (Publication Type: Journal Article)
• Copyright: Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Chemical References

• Biomarkers
• Blood Glucose

Topics

• Adult
• Biomarkers (blood)
• Blood Glucose (metabolism)
• Body Mass Index
• Diabetes, Gestational (blood, diagnosis)
• Fasting
• Female
• Fetal Macrosomia (blood, diagnosis)
• France
• Glucose Tolerance Test
• Humans
• Infant, Newborn
• Odds Ratio
• Parity
• Practice Guidelines as Topic
• Predictive Value of Tests
• Pregnancy
• Retrospective Studies
• Weight Gain