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Can plasma glucose and HbA1c predict fetal growth in mothers with different glucose tolerance levels?
Diabetes Res Clin Pract 2007; 77(3):465-70DR

Abstract

To assess whether HbA1c and plasma glucose predicts abnormal fetal growth, 758 pregnant women attending 5 Diabetic Centers were screened for gestational diabetes mellitus (GDM). On glucose challenge (GCT) at 24-27 weeks of gestation (g.w.), negative cases formed the normal control group (N1). Positive cases took an oral glucose tolerance test (OGTT): those found negative were classed as false positives screening test (N2); if they had an OGTT result at least as high as their normal glucose levels, they were classed as having one abnormal glucose value (OAV) at OGTT; two values as GDM. HbA1c was assayed on the day of GCT. We considered fetal macrosomia, large for gestational age (LGA), ponderal index and mean growth percentile. Mean age, pre-pregnancy BMI, fasting plasma glucose (FPG) and HbA1c were progressively higher from N1 to GDM patients. The newborn of N2 mothers were heavier than those with N1 or GDM. The mean growth percentile was significantly higher in N2 than in N1. More LGA babies were born to OAV than to N1 or N2 women. Macrosomia and ponderal index did not differ significantly in the four groups. At logistic regression only plasma glucose at GCT could predict LGA babies and a ponderal index above 2.85. At risk analysis, GDM and OAV significantly predicted LGA babies, and GDM a ponderal index >2.85. In conclusion, FPG at GCT could predict fetal overgrowth and plasma glucose >85mg/dl doubles the risk of LGA infants. HbA1c at 24-27g.w. does not predict fetal overgrowth. Mild alterations in glucose tolerance correlate with fetal overgrowth and needs monitoring and treatment.

Authors+Show Affiliations

Dipartimento di Scienze Mediche e Chirurgiche-Cattedra di Malattie del Metabolismo, Università di Padova, Via Giustinuani n. 2, 35100 Padua, Italy. annunziata.lapolla@unipd.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

17350135

Citation

Lapolla, A, et al. "Can Plasma Glucose and HbA1c Predict Fetal Growth in Mothers With Different Glucose Tolerance Levels?" Diabetes Research and Clinical Practice, vol. 77, no. 3, 2007, pp. 465-70.
Lapolla A, Dalfrà MG, Bonomo M, et al. Can plasma glucose and HbA1c predict fetal growth in mothers with different glucose tolerance levels? Diabetes Res Clin Pract. 2007;77(3):465-70.
Lapolla, A., Dalfrà, M. G., Bonomo, M., Castiglioni, M. T., Di Cianni, G., Masin, M., ... Mosca, A. (2007). Can plasma glucose and HbA1c predict fetal growth in mothers with different glucose tolerance levels? Diabetes Research and Clinical Practice, 77(3), pp. 465-70.
Lapolla A, et al. Can Plasma Glucose and HbA1c Predict Fetal Growth in Mothers With Different Glucose Tolerance Levels. Diabetes Res Clin Pract. 2007;77(3):465-70. PubMed PMID: 17350135.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Can plasma glucose and HbA1c predict fetal growth in mothers with different glucose tolerance levels? AU - Lapolla,A, AU - Dalfrà,M G, AU - Bonomo,M, AU - Castiglioni,M T, AU - Di Cianni,G, AU - Masin,M, AU - Mion,E, AU - Paleari,R, AU - Schievano,C, AU - Songini,M, AU - Tocco,G, AU - Volpe,L, AU - Mosca,A, Y1 - 2007/03/09/ PY - 2006/09/08/received PY - 2007/01/24/accepted PY - 2007/3/14/pubmed PY - 2007/12/18/medline PY - 2007/3/14/entrez SP - 465 EP - 70 JF - Diabetes research and clinical practice JO - Diabetes Res. Clin. Pract. VL - 77 IS - 3 N2 - To assess whether HbA1c and plasma glucose predicts abnormal fetal growth, 758 pregnant women attending 5 Diabetic Centers were screened for gestational diabetes mellitus (GDM). On glucose challenge (GCT) at 24-27 weeks of gestation (g.w.), negative cases formed the normal control group (N1). Positive cases took an oral glucose tolerance test (OGTT): those found negative were classed as false positives screening test (N2); if they had an OGTT result at least as high as their normal glucose levels, they were classed as having one abnormal glucose value (OAV) at OGTT; two values as GDM. HbA1c was assayed on the day of GCT. We considered fetal macrosomia, large for gestational age (LGA), ponderal index and mean growth percentile. Mean age, pre-pregnancy BMI, fasting plasma glucose (FPG) and HbA1c were progressively higher from N1 to GDM patients. The newborn of N2 mothers were heavier than those with N1 or GDM. The mean growth percentile was significantly higher in N2 than in N1. More LGA babies were born to OAV than to N1 or N2 women. Macrosomia and ponderal index did not differ significantly in the four groups. At logistic regression only plasma glucose at GCT could predict LGA babies and a ponderal index above 2.85. At risk analysis, GDM and OAV significantly predicted LGA babies, and GDM a ponderal index >2.85. In conclusion, FPG at GCT could predict fetal overgrowth and plasma glucose >85mg/dl doubles the risk of LGA infants. HbA1c at 24-27g.w. does not predict fetal overgrowth. Mild alterations in glucose tolerance correlate with fetal overgrowth and needs monitoring and treatment. SN - 0168-8227 UR - https://www.unboundmedicine.com/medline/citation/17350135/Can_plasma_glucose_and_HbA1c_predict_fetal_growth_in_mothers_with_different_glucose_tolerance_levels L2 - https://linkinghub.elsevier.com/retrieve/pii/S0168-8227(07)00060-5 DB - PRIME DP - Unbound Medicine ER -