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Detection of pregnancies with high risk of fetal macrosomia among women with gestational diabetes mellitus.
Acta Obstet Gynecol Scand 2008; 87(9):940-5AO

Abstract

OBJECTIVE

To compare the frequency of fetal macrosomia and Erb's palsy in two groups of women with gestational diabetes mellitus (GDM) and in healthy controls.

DESIGN

Retrospective clinical study of women with GDM.

SETTING

Pregnant women in Greater Helsinki area.

POPULATION

Nine hundred and five pregnancies and newborn infants of women with GDM and 805 non-diabetic controls.

METHODS

GDM was diagnosed by a 2-hour oral glucose tolerance test (OGTT) among women with risk factors for GDM. The treatment of GDM was resolved by a 24-hour glucose profile obtained after 2 or 3 abnormal glucose values in the OGTT. Patients with a history of insulin-treated GDM in a previous pregnancy and those with a fasting glucose over 6 mmol/l underwent a 24-h glucose profile directly without a preceding OGTT.

MAIN OUTCOME MEASURES

Fetal macrosomia, defined as a birth weight (adjusted for sex and gestational age) of >2.0 SD above the mean of a Finnish standard population. Erb's palsy.

RESULTS

385 women (42.5%) were treated with insulin and diet and 520 (57.5%) with diet only. Macrosomia occurred more often in the insulin-treated group (18.2%, p<0.001) compared with the diet-treated group (4.4%) and the controls (2.2%). The rate of Erb's palsy was 2.7% in the insulin-treated group, 2.4% in the diet-treated group, compared with 0.3% in the controls (p<0.001).

CONCLUSION

The 24-hour glucose profile performed after the diagnosis of GDM clearly distinguishes between low-risk (diet-treated) and high-risk (insulin-treated) for fetal macrosomia in GDM pregnancies.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland. lauri.suhonen@hus.fiNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18728914

Citation

Suhonen, Lauri, et al. "Detection of Pregnancies With High Risk of Fetal Macrosomia Among Women With Gestational Diabetes Mellitus." Acta Obstetricia Et Gynecologica Scandinavica, vol. 87, no. 9, 2008, pp. 940-5.
Suhonen L, Hiilesmaa V, Kaaja R, et al. Detection of pregnancies with high risk of fetal macrosomia among women with gestational diabetes mellitus. Acta Obstet Gynecol Scand. 2008;87(9):940-5.
Suhonen, L., Hiilesmaa, V., Kaaja, R., & Teramo, K. (2008). Detection of pregnancies with high risk of fetal macrosomia among women with gestational diabetes mellitus. Acta Obstetricia Et Gynecologica Scandinavica, 87(9), pp. 940-5. doi:10.1080/00016340802334377.
Suhonen L, et al. Detection of Pregnancies With High Risk of Fetal Macrosomia Among Women With Gestational Diabetes Mellitus. Acta Obstet Gynecol Scand. 2008;87(9):940-5. PubMed PMID: 18728914.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Detection of pregnancies with high risk of fetal macrosomia among women with gestational diabetes mellitus. AU - Suhonen,Lauri, AU - Hiilesmaa,Vilho, AU - Kaaja,Risto, AU - Teramo,Kari, PY - 2008/8/30/pubmed PY - 2008/9/30/medline PY - 2008/8/30/entrez SP - 940 EP - 5 JF - Acta obstetricia et gynecologica Scandinavica JO - Acta Obstet Gynecol Scand VL - 87 IS - 9 N2 - OBJECTIVE: To compare the frequency of fetal macrosomia and Erb's palsy in two groups of women with gestational diabetes mellitus (GDM) and in healthy controls. DESIGN: Retrospective clinical study of women with GDM. SETTING: Pregnant women in Greater Helsinki area. POPULATION: Nine hundred and five pregnancies and newborn infants of women with GDM and 805 non-diabetic controls. METHODS: GDM was diagnosed by a 2-hour oral glucose tolerance test (OGTT) among women with risk factors for GDM. The treatment of GDM was resolved by a 24-hour glucose profile obtained after 2 or 3 abnormal glucose values in the OGTT. Patients with a history of insulin-treated GDM in a previous pregnancy and those with a fasting glucose over 6 mmol/l underwent a 24-h glucose profile directly without a preceding OGTT. MAIN OUTCOME MEASURES: Fetal macrosomia, defined as a birth weight (adjusted for sex and gestational age) of >2.0 SD above the mean of a Finnish standard population. Erb's palsy. RESULTS: 385 women (42.5%) were treated with insulin and diet and 520 (57.5%) with diet only. Macrosomia occurred more often in the insulin-treated group (18.2%, p<0.001) compared with the diet-treated group (4.4%) and the controls (2.2%). The rate of Erb's palsy was 2.7% in the insulin-treated group, 2.4% in the diet-treated group, compared with 0.3% in the controls (p<0.001). CONCLUSION: The 24-hour glucose profile performed after the diagnosis of GDM clearly distinguishes between low-risk (diet-treated) and high-risk (insulin-treated) for fetal macrosomia in GDM pregnancies. SN - 1600-0412 UR - https://www.unboundmedicine.com/medline/citation/18728914/Detection_of_pregnancies_with_high_risk_of_fetal_macrosomia_among_women_with_gestational_diabetes_mellitus_ L2 - https://doi.org/10.1080/00016340802334377 DB - PRIME DP - Unbound Medicine ER -