Fetal growth profiles of macrosomic and non‐macrosomic infants of women with pregestational or gestational diabetes
ABSTRACT Objective To assess fetal growth profiles in an unselected group of pregnant women with either Type‐1 diabetes (DM1), Type‐2 diabetes (DM2) or gestational diabetes (GDM), with emphasis on intergroup differences and development of disproportionate fetal growth and macrosomia. Methods Second‐...
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Veröffentlicht in: | Ultrasound in obstetrics & gynecology 2013-04, Vol.41 (4), p.390-397 |
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creator | Hammoud, N. M. Visser, G. H. A. Peters, S. A. E. Graatsma, E. M. Pistorius, L. de Valk, H. W. |
description | ABSTRACT
Objective
To assess fetal growth profiles in an unselected group of pregnant women with either Type‐1 diabetes (DM1), Type‐2 diabetes (DM2) or gestational diabetes (GDM), with emphasis on intergroup differences and development of disproportionate fetal growth and macrosomia.
Methods
Second‐ and third‐trimester longitudinal ultrasound measurements of fetal growth were made in 77 women with DM1, 68 women with DM2 and in 99 women with GDM. Altogether 897 ultrasound examinations were performed and 145 uncomplicated pregnancies with 843 ultrasound examinations were included as controls. Ultrasound data included head circumference (HC), abdominal circumference (AC), femur length (FL) and HC/AC ratio.
Results
The AC, but not HC and FL, evolved differently in diabetic pregnancies, with a smaller AC in early pregnancy and larger AC at term (significant for DM1 and DM2). The most striking differences were found for the HC/AC ratio, especially in DM1 pregnancies. HC/AC growth trajectories of both macrosomic and non‐macrosomic fetuses differed from that of the controls, and the HC/AC ratio at term was lower in all diabetic subgroups except in non‐macrosomic DM2 cases.
Conclusion
We found altered (disproportionate) fetal growth in macrosomic and non‐macrosomic fetuses of women with DM1, DM2 and GDM. This indicates that the abnormal intrauterine environment affects the majority of these infants. Growth profiles differed among these groups, the most prominent growth deviations being found in the fetuses of women with DM1. The latter was most probably caused by poor glucose control. In monitoring fetal growth in diabetic pregnancies the HC/AC ratio should be used to assess altered fetal growth. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd. |
doi_str_mv | 10.1002/uog.11221 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1434026970</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1434026970</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4211-b1ba305cb56f25cb8bcbf06b2b327ab0349bbaff0e617107b2481483090877da3</originalsourceid><addsrcrecordid>eNqFkc1KAzEURoMoWqsLX0AG3Ohi2nuTNOkspdgqCN3Y9ZBMkzoyM9HJDKU7H8Fn9ElMf5QiiGRxSTgc8t2PkAuEHgLQfusWPURK8YB0kIskBgmDQ9KBREAsRUJPyKn3LwAgOBPH5IRSyfkQZYe0Y9OoIlrUbtk8R6-1s3lhfORsVKqsdt6VeRapah5Vrvp8_9h7zCurqmaDLl1pqmiZbwxmYXyjmtxVwevqaP86z5U2jfFn5Miqwpvz3eyS2fjuaXQfP04nD6PbxzjjFDHWqBWDQaYHwtIwhjrTFoSmmlGpNDCeaK2sBSNQIkhNQyg-ZJDAUMq5Yl1yvfWGYG9t-Eha5j4zRaEq41qfImccqEgk_I8yCigoC_ouufqFvri2Dvk2FEUeDgbqZkutN-ZrY9PXOi9VvUoR0nVtaagt3dQW2MudsdWlmf-Q3z0FoL8FlqGe1d-mdDadbJVfH_ui6w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1322141411</pqid></control><display><type>article</type><title>Fetal growth profiles of macrosomic and non‐macrosomic infants of women with pregestational or gestational diabetes</title><source>Wiley Free Content</source><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Hammoud, N. M. ; Visser, G. H. A. ; Peters, S. A. E. ; Graatsma, E. M. ; Pistorius, L. ; de Valk, H. W.</creator><creatorcontrib>Hammoud, N. M. ; Visser, G. H. A. ; Peters, S. A. E. ; Graatsma, E. M. ; Pistorius, L. ; de Valk, H. W.</creatorcontrib><description>ABSTRACT
Objective
To assess fetal growth profiles in an unselected group of pregnant women with either Type‐1 diabetes (DM1), Type‐2 diabetes (DM2) or gestational diabetes (GDM), with emphasis on intergroup differences and development of disproportionate fetal growth and macrosomia.
Methods
Second‐ and third‐trimester longitudinal ultrasound measurements of fetal growth were made in 77 women with DM1, 68 women with DM2 and in 99 women with GDM. Altogether 897 ultrasound examinations were performed and 145 uncomplicated pregnancies with 843 ultrasound examinations were included as controls. Ultrasound data included head circumference (HC), abdominal circumference (AC), femur length (FL) and HC/AC ratio.
Results
The AC, but not HC and FL, evolved differently in diabetic pregnancies, with a smaller AC in early pregnancy and larger AC at term (significant for DM1 and DM2). The most striking differences were found for the HC/AC ratio, especially in DM1 pregnancies. HC/AC growth trajectories of both macrosomic and non‐macrosomic fetuses differed from that of the controls, and the HC/AC ratio at term was lower in all diabetic subgroups except in non‐macrosomic DM2 cases.
Conclusion
We found altered (disproportionate) fetal growth in macrosomic and non‐macrosomic fetuses of women with DM1, DM2 and GDM. This indicates that the abnormal intrauterine environment affects the majority of these infants. Growth profiles differed among these groups, the most prominent growth deviations being found in the fetuses of women with DM1. The latter was most probably caused by poor glucose control. In monitoring fetal growth in diabetic pregnancies the HC/AC ratio should be used to assess altered fetal growth. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.</description><identifier>ISSN: 0960-7692</identifier><identifier>EISSN: 1469-0705</identifier><identifier>DOI: 10.1002/uog.11221</identifier><identifier>PMID: 22744817</identifier><identifier>CODEN: UOGYFJ</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Adult ; Case-Control Studies ; Diabetes Mellitus, Type 1 - physiopathology ; Diabetes Mellitus, Type 2 - physiopathology ; Diabetes, Gestational - physiopathology ; diabetic pregnancies ; disproportionate growth ; Female ; Fetal Development - physiology ; fetal growth ; Fetal Macrosomia - diagnostic imaging ; Fetal Macrosomia - physiopathology ; gestational diabetes ; Humans ; Longitudinal Studies ; macrosomia ; Male ; pregestational diabetes ; Pregnancy ; Pregnancy in Diabetics - physiopathology ; Risk Factors ; Ultrasonography, Prenatal ; Young Adult</subject><ispartof>Ultrasound in obstetrics & gynecology, 2013-04, Vol.41 (4), p.390-397</ispartof><rights>Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.</rights><rights>Copyright © 2013 ISUOG. Published by John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4211-b1ba305cb56f25cb8bcbf06b2b327ab0349bbaff0e617107b2481483090877da3</citedby><cites>FETCH-LOGICAL-c4211-b1ba305cb56f25cb8bcbf06b2b327ab0349bbaff0e617107b2481483090877da3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fuog.11221$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fuog.11221$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22744817$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hammoud, N. M.</creatorcontrib><creatorcontrib>Visser, G. H. A.</creatorcontrib><creatorcontrib>Peters, S. A. E.</creatorcontrib><creatorcontrib>Graatsma, E. M.</creatorcontrib><creatorcontrib>Pistorius, L.</creatorcontrib><creatorcontrib>de Valk, H. W.</creatorcontrib><title>Fetal growth profiles of macrosomic and non‐macrosomic infants of women with pregestational or gestational diabetes</title><title>Ultrasound in obstetrics & gynecology</title><addtitle>Ultrasound Obstet Gynecol</addtitle><description>ABSTRACT
Objective
To assess fetal growth profiles in an unselected group of pregnant women with either Type‐1 diabetes (DM1), Type‐2 diabetes (DM2) or gestational diabetes (GDM), with emphasis on intergroup differences and development of disproportionate fetal growth and macrosomia.
Methods
Second‐ and third‐trimester longitudinal ultrasound measurements of fetal growth were made in 77 women with DM1, 68 women with DM2 and in 99 women with GDM. Altogether 897 ultrasound examinations were performed and 145 uncomplicated pregnancies with 843 ultrasound examinations were included as controls. Ultrasound data included head circumference (HC), abdominal circumference (AC), femur length (FL) and HC/AC ratio.
Results
The AC, but not HC and FL, evolved differently in diabetic pregnancies, with a smaller AC in early pregnancy and larger AC at term (significant for DM1 and DM2). The most striking differences were found for the HC/AC ratio, especially in DM1 pregnancies. HC/AC growth trajectories of both macrosomic and non‐macrosomic fetuses differed from that of the controls, and the HC/AC ratio at term was lower in all diabetic subgroups except in non‐macrosomic DM2 cases.
Conclusion
We found altered (disproportionate) fetal growth in macrosomic and non‐macrosomic fetuses of women with DM1, DM2 and GDM. This indicates that the abnormal intrauterine environment affects the majority of these infants. Growth profiles differed among these groups, the most prominent growth deviations being found in the fetuses of women with DM1. The latter was most probably caused by poor glucose control. In monitoring fetal growth in diabetic pregnancies the HC/AC ratio should be used to assess altered fetal growth. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.</description><subject>Adult</subject><subject>Case-Control Studies</subject><subject>Diabetes Mellitus, Type 1 - physiopathology</subject><subject>Diabetes Mellitus, Type 2 - physiopathology</subject><subject>Diabetes, Gestational - physiopathology</subject><subject>diabetic pregnancies</subject><subject>disproportionate growth</subject><subject>Female</subject><subject>Fetal Development - physiology</subject><subject>fetal growth</subject><subject>Fetal Macrosomia - diagnostic imaging</subject><subject>Fetal Macrosomia - physiopathology</subject><subject>gestational diabetes</subject><subject>Humans</subject><subject>Longitudinal Studies</subject><subject>macrosomia</subject><subject>Male</subject><subject>pregestational diabetes</subject><subject>Pregnancy</subject><subject>Pregnancy in Diabetics - physiopathology</subject><subject>Risk Factors</subject><subject>Ultrasonography, Prenatal</subject><subject>Young Adult</subject><issn>0960-7692</issn><issn>1469-0705</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc1KAzEURoMoWqsLX0AG3Ohi2nuTNOkspdgqCN3Y9ZBMkzoyM9HJDKU7H8Fn9ElMf5QiiGRxSTgc8t2PkAuEHgLQfusWPURK8YB0kIskBgmDQ9KBREAsRUJPyKn3LwAgOBPH5IRSyfkQZYe0Y9OoIlrUbtk8R6-1s3lhfORsVKqsdt6VeRapah5Vrvp8_9h7zCurqmaDLl1pqmiZbwxmYXyjmtxVwevqaP86z5U2jfFn5Miqwpvz3eyS2fjuaXQfP04nD6PbxzjjFDHWqBWDQaYHwtIwhjrTFoSmmlGpNDCeaK2sBSNQIkhNQyg-ZJDAUMq5Yl1yvfWGYG9t-Eha5j4zRaEq41qfImccqEgk_I8yCigoC_ouufqFvri2Dvk2FEUeDgbqZkutN-ZrY9PXOi9VvUoR0nVtaagt3dQW2MudsdWlmf-Q3z0FoL8FlqGe1d-mdDadbJVfH_ui6w</recordid><startdate>201304</startdate><enddate>201304</enddate><creator>Hammoud, N. M.</creator><creator>Visser, G. H. A.</creator><creator>Peters, S. A. E.</creator><creator>Graatsma, E. M.</creator><creator>Pistorius, L.</creator><creator>de Valk, H. W.</creator><general>John Wiley & Sons, Ltd</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>201304</creationdate><title>Fetal growth profiles of macrosomic and non‐macrosomic infants of women with pregestational or gestational diabetes</title><author>Hammoud, N. M. ; Visser, G. H. A. ; Peters, S. A. E. ; Graatsma, E. M. ; Pistorius, L. ; de Valk, H. W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4211-b1ba305cb56f25cb8bcbf06b2b327ab0349bbaff0e617107b2481483090877da3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Case-Control Studies</topic><topic>Diabetes Mellitus, Type 1 - physiopathology</topic><topic>Diabetes Mellitus, Type 2 - physiopathology</topic><topic>Diabetes, Gestational - physiopathology</topic><topic>diabetic pregnancies</topic><topic>disproportionate growth</topic><topic>Female</topic><topic>Fetal Development - physiology</topic><topic>fetal growth</topic><topic>Fetal Macrosomia - diagnostic imaging</topic><topic>Fetal Macrosomia - physiopathology</topic><topic>gestational diabetes</topic><topic>Humans</topic><topic>Longitudinal Studies</topic><topic>macrosomia</topic><topic>Male</topic><topic>pregestational diabetes</topic><topic>Pregnancy</topic><topic>Pregnancy in Diabetics - physiopathology</topic><topic>Risk Factors</topic><topic>Ultrasonography, Prenatal</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hammoud, N. M.</creatorcontrib><creatorcontrib>Visser, G. H. A.</creatorcontrib><creatorcontrib>Peters, S. A. E.</creatorcontrib><creatorcontrib>Graatsma, E. M.</creatorcontrib><creatorcontrib>Pistorius, L.</creatorcontrib><creatorcontrib>de Valk, H. W.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Ultrasound in obstetrics & gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hammoud, N. M.</au><au>Visser, G. H. A.</au><au>Peters, S. A. E.</au><au>Graatsma, E. M.</au><au>Pistorius, L.</au><au>de Valk, H. W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Fetal growth profiles of macrosomic and non‐macrosomic infants of women with pregestational or gestational diabetes</atitle><jtitle>Ultrasound in obstetrics & gynecology</jtitle><addtitle>Ultrasound Obstet Gynecol</addtitle><date>2013-04</date><risdate>2013</risdate><volume>41</volume><issue>4</issue><spage>390</spage><epage>397</epage><pages>390-397</pages><issn>0960-7692</issn><eissn>1469-0705</eissn><coden>UOGYFJ</coden><abstract>ABSTRACT
Objective
To assess fetal growth profiles in an unselected group of pregnant women with either Type‐1 diabetes (DM1), Type‐2 diabetes (DM2) or gestational diabetes (GDM), with emphasis on intergroup differences and development of disproportionate fetal growth and macrosomia.
Methods
Second‐ and third‐trimester longitudinal ultrasound measurements of fetal growth were made in 77 women with DM1, 68 women with DM2 and in 99 women with GDM. Altogether 897 ultrasound examinations were performed and 145 uncomplicated pregnancies with 843 ultrasound examinations were included as controls. Ultrasound data included head circumference (HC), abdominal circumference (AC), femur length (FL) and HC/AC ratio.
Results
The AC, but not HC and FL, evolved differently in diabetic pregnancies, with a smaller AC in early pregnancy and larger AC at term (significant for DM1 and DM2). The most striking differences were found for the HC/AC ratio, especially in DM1 pregnancies. HC/AC growth trajectories of both macrosomic and non‐macrosomic fetuses differed from that of the controls, and the HC/AC ratio at term was lower in all diabetic subgroups except in non‐macrosomic DM2 cases.
Conclusion
We found altered (disproportionate) fetal growth in macrosomic and non‐macrosomic fetuses of women with DM1, DM2 and GDM. This indicates that the abnormal intrauterine environment affects the majority of these infants. Growth profiles differed among these groups, the most prominent growth deviations being found in the fetuses of women with DM1. The latter was most probably caused by poor glucose control. In monitoring fetal growth in diabetic pregnancies the HC/AC ratio should be used to assess altered fetal growth. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>22744817</pmid><doi>10.1002/uog.11221</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adult Case-Control Studies Diabetes Mellitus, Type 1 - physiopathology Diabetes Mellitus, Type 2 - physiopathology Diabetes, Gestational - physiopathology diabetic pregnancies disproportionate growth Female Fetal Development - physiology fetal growth Fetal Macrosomia - diagnostic imaging Fetal Macrosomia - physiopathology gestational diabetes Humans Longitudinal Studies macrosomia Male pregestational diabetes Pregnancy Pregnancy in Diabetics - physiopathology Risk Factors Ultrasonography, Prenatal Young Adult |
title | Fetal growth profiles of macrosomic and non‐macrosomic infants of women with pregestational or gestational diabetes |
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