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Increased risk of macrosomia among overweight women with high gestational rise in fasting glucose.
J Matern Fetal Neonatal Med. 2010 Jan; 23(1):74-81.JM

Abstract

OBJECTIVES

Maternal overweight is a risk factor for gestational diabetes (GDM) and for newborn macrosomia. Among women without GDM, it is not well understood why some women with high body mass index (BMI) give birth to macrosomic newborns while others do not. We wanted to explore the effect of BMI and fasting plasma glucose (FPG), fasting plasma insulin (FPI) and insulin resistance (HOMA-IR) on the risk of newborn macrosomia.

METHODS

A cohort of 553 Caucasian women was followed throughout pregnancy. The dependent variable was high birth weight (>or=4200 g). Independent variables included gestational age, intake of macronutrients and energy, maternal BMI, weight gain, FPG, FPI and HOMA-IR.

RESULTS

FPG in late pregnancy (30-32 weeks) remained a significant determinant of newborn macrosomia in multiple regression analysis (OR: 1.9, 95% CI: [1.1, 3.4]), whereas FPI and HOMA-IR did not. The women in the highest BMI quartile (>or=27 kg/m(2)) who gave birth to macrosomic newborns had higher increase in FPG and HOMA-IR from early to late pregnancy. Among women in this BMI category, the risk for delivering a macrosomic infant was higher among those with an increase in FPG above 0.60 mmol/l (upper quartile) (OR = 4.5, 95% CI: [1.7, 12.5]).

CONCLUSION

Fasting plasma glucose at week 30-32, but not fasting plasma insulin or insulin resistance, is a determinant of newborn macrosomia. Overweight women with high increase in fasting plasma glucose from early to late pregnancy had a 4.5-fold increase in risk of newborn macrosomia compared to the remaining group with high BMI.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Rikshospitalet, University of Oslo, Oslo, Norway. nanna.voldner@rikshospitalet.noNo affiliation info availableNo affiliation info availableNo 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

19626569

Citation

Voldner, Nanna, et al. "Increased Risk of Macrosomia Among Overweight Women With High Gestational Rise in Fasting Glucose." The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, vol. 23, no. 1, 2010, pp. 74-81.
Voldner N, Qvigstad E, Frøslie KF, et al. Increased risk of macrosomia among overweight women with high gestational rise in fasting glucose. J Matern Fetal Neonatal Med. 2010;23(1):74-81.
Voldner, N., Qvigstad, E., Frøslie, K. F., Godang, K., Henriksen, T., & Bollerslev, J. (2010). Increased risk of macrosomia among overweight women with high gestational rise in fasting glucose. The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 23(1), 74-81. https://doi.org/10.3109/14767050903121472
Voldner N, et al. Increased Risk of Macrosomia Among Overweight Women With High Gestational Rise in Fasting Glucose. J Matern Fetal Neonatal Med. 2010;23(1):74-81. PubMed PMID: 19626569.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased risk of macrosomia among overweight women with high gestational rise in fasting glucose. AU - Voldner,Nanna, AU - Qvigstad,Elisabeth, AU - Frøslie,Kathrine Frey, AU - Godang,Kristin, AU - Henriksen,Tore, AU - Bollerslev,Jens, PY - 2009/7/24/entrez PY - 2009/7/25/pubmed PY - 2010/2/26/medline SP - 74 EP - 81 JF - The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians JO - J Matern Fetal Neonatal Med VL - 23 IS - 1 N2 - OBJECTIVES: Maternal overweight is a risk factor for gestational diabetes (GDM) and for newborn macrosomia. Among women without GDM, it is not well understood why some women with high body mass index (BMI) give birth to macrosomic newborns while others do not. We wanted to explore the effect of BMI and fasting plasma glucose (FPG), fasting plasma insulin (FPI) and insulin resistance (HOMA-IR) on the risk of newborn macrosomia. METHODS: A cohort of 553 Caucasian women was followed throughout pregnancy. The dependent variable was high birth weight (>or=4200 g). Independent variables included gestational age, intake of macronutrients and energy, maternal BMI, weight gain, FPG, FPI and HOMA-IR. RESULTS: FPG in late pregnancy (30-32 weeks) remained a significant determinant of newborn macrosomia in multiple regression analysis (OR: 1.9, 95% CI: [1.1, 3.4]), whereas FPI and HOMA-IR did not. The women in the highest BMI quartile (>or=27 kg/m(2)) who gave birth to macrosomic newborns had higher increase in FPG and HOMA-IR from early to late pregnancy. Among women in this BMI category, the risk for delivering a macrosomic infant was higher among those with an increase in FPG above 0.60 mmol/l (upper quartile) (OR = 4.5, 95% CI: [1.7, 12.5]). CONCLUSION: Fasting plasma glucose at week 30-32, but not fasting plasma insulin or insulin resistance, is a determinant of newborn macrosomia. Overweight women with high increase in fasting plasma glucose from early to late pregnancy had a 4.5-fold increase in risk of newborn macrosomia compared to the remaining group with high BMI. SN - 1476-4954 UR - https://www.unboundmedicine.com/medline/citation/19626569/Increased_risk_of_macrosomia_among_overweight_women_with_high_gestational_rise_in_fasting_glucose_ L2 - https://www.tandfonline.com/doi/full/10.3109/14767050903121472 DB - PRIME DP - Unbound Medicine ER -