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PubMed1998

Growth hormone, insulin-like growth factor-I and insulin-like growth factor binding protein-3 are regulated differently in small-for-gestational-age and appropriate-for-gestational-age neonates.

Growth hormone (GH), insulin-like growth factor-I (IGF-I) and IGF-binding protein-3 (IGFBP-3) were measured in 90 neonates during the first 5 days of life. Twenty-six small-for-gestational-age (SGA) neonates were compared with 64 appropriate-for-gestational-age (AGA) neonates. There were no differences in nutritional status between the 2 groups. Mean GH levels were significantly higher in the SGA group (53.4 +/- 30.8 vs. 39.9 +/- 23.3 microg/l; p < 0.05). In both groups GH levels correlated with birth weight (expressed as SDS) but not with gestational age. IGF-I levels were significantly lower in SGA neonates (6.6 +/- 4.0 vs. 11.7 +/- 8.2 ng/ml; p < 0.01). In SGA neonates with short stature, IGF-I levels were lower and GH levels were higher than in normal stature SGA neonates. IGFBP-3 levels were significantly lower in SGA neonates than in AGA neonates (0.72 +/- 0.40 vs. 0.98 +/- 0.43 microg/l; p < 0.01). IGF-I and IGFBP-3 correlated with gestational age in AGA but not in SGA neonates and there was no correlation with birth weight in either group. Our data provide evidence for a graduation in the severity of impact of fetal 'malnutrition' on the somatotropic axis and on intrauterine growth. The most severe state (SGA with short stature) was associated with a GH-resistance syndrome, characterized by very low IGF-I levels and high GH levels.

Body Height↗

PubMed2003

Catch-up growth in females born short for gestational age reduces the risk of giving birth to short-for-gestational-age infants.

OBJECTIVES: The aim of the present study was to study the effect of catch-up growth on the offspring's length at birth among females born short for gestational age. METHODS: Data of 1,363 females born short for gestational age (<-2 standard deviation scores) were obtained from the Swedish Birth Register. The females were included in the register both as babies and mothers. The effect of catch-up growth on the offspring's birth length was studied. RESULTS: Short adult stature was associated with a threefold increase in the risk of giving birth to a short infant [OR 3.08 (CI 1.73-5.50)] and smoking increased the risk in a dose-dependent manner. Overweight was associated with a reduced risk [OR 0.46 (CI 0.22-0.96)] of giving birth to a short infant. CONCLUSION: Catch-up growth to normal adult stature among women born short for gestational age is associated with a reduced risk of giving birth to a short-for-gestational-age infant.

Adolescent↗

PubMed1998

Fluid abnormalities occur in the chronically cannulated mid-gestation but not late gestation ovine fetus.

Hydrops fetalis, with or without oligo- or polyhydramnios, is associated with very high fetal mortality. In many cases the causes are unknown. Chronically cannulated ovine fetuses have been used as animal models to study the regulation of fetal fluid balance. This study reports that the mid-gestation ovine fetus (70 +/- 1 d of gestation; term = 145-150 d) is susceptible to the development of fetal abnormalities (excess allantoic fluid--hydrallantois, with or without hydrops and hydranencephaly), when blood vessels in the neck are cannulated. Cannulation of one carotid artery and one jugular vein, or cannulation of a single jugular vein resulted in 5 out of 12 fetuses having abnormalities 1 wk later. In contrast, six fetuses at 115 d of gestation that had both carotids and one jugular vein ligated cranially and cannulated, developed hydranencephaly but no hydrops or hydrallantois. In the mid-gestation fetus hydrallantois [760 +/- 140 mL (n = 5) versus 104 +/- 23 mL (n = 7 controls), p < 0.001] occurred without alterations in the plasma concentrations of ACTH, cortisol, atrial natriuretic peptide, or aldosterone, as well as without anemia. Although the causes of the fluid abnormalities were not resolved, it is important to note the developmental differences in vulnerability.

Adrenocorticotropic Hormone↗

PubMed1999

Effect of maternal nutrient restriction in early gestation on development of the hypothalamic-pituitary-adrenal axis in fetal sheep at 0.8-0.9 of gestation.

The fetal hypothalamic-pituitary-adrenal (HPA) axis has numerous key roles in development. Epidemiological data have linked adverse prenatal nutrition with altered organ development and increased incidence of disease in adult life. We studied HPA axis development in resting and stimulated states in late gestation fetal sheep, following 15% reduction in maternal nutritional intake over the first 70 days of gestation (dGA). Fetuses from control (C) and nutrient-restricted (R) ewes were chronically catheterised and response profiles for ACTH and cortisol were determined at 113-116 and 125-127 dGA after administration of corticotrophin releasing hormone (CRH) and arginine vasopressin (AVP). At 126-128 dGA cortisol profiles were also determined following ACTH administration. Basal ACTH and cortisol concentrations were not different between C and R fetuses. In R fetuses, ACTH response to CRH+AVP was significantly smaller at 113-116 dGA (P<0.01), and cortisol responses were smaller at both 113-116 dGA (P<0.01) and 125-127 dGA (P<0.0001). Cortisol response to ACTH was also smaller in R fetuses (P<0.001). We conclude that, in late gestation fetal sheep, pituitary and adrenal responsiveness is reduced following modest maternal nutrient restriction in early gestation.

Adrenocorticotropic Hormone↗

PubMed1998

Fasting plasma glucose is a useful test for the detection of gestational diabetes. Brazilian Study of Gestational Diabetes (EBDG) Working Group.

OBJECTIVE: To evaluate fasting plasma glucose as a screening test for states of gestational diabetes. RESEARCH DESIGN AND METHODS: Baseline data of a cohort conducted in general prenatal care units in Brazil, enrolling 5,579 women aged > or = 20 years with gestational ages of 24-28 weeks at the time of testing and no previous diagnosis of diabetes. A standardized 2-h 75-g oral glucose tolerance test was performed in 5,010 women. Gestational diabetes and its subcategories--diabetes and impaired glucose tolerance--were defined according to the 1994 World Health Organization panel recommendations. We evaluated screening properties of calculated sensitivity and specificity for fasting plasma glucose with receiver operator characteristic curves. RESULTS: For detection of the subcategory diabetes, a fasting plasma glucose of 89 mg/dl jointly maximizes sensitivity (88%) and specificity (78%), identifying 22% of the women as test-positive. For detection of impaired glucose tolerance, a value of 85 mg/dl jointly maximizes sensitivity and specificity (68%), identifying as test-positive 35% of the women. Lowering the cut point to 81 mg/dl increases sensitivity to 81%, but decreases specificity to 54%, labeling as test-positive 49% of the women. CONCLUSIONS: Fasting plasma glucose is a useful test for the screening of both subcategories of gestational diabetes, a threshold of 85 mg/dl being an acceptable option. Effective screening for the subcategory diabetes can be achieved using a cut point of 89 mg/dl. If greater emphasis is placed on the detection of impaired glucose tolerance, a lower value, 81 mg/dl, may be needed.

Adult↗

PubMed2006

Pregnancy outcomes in pre-gestational and gestational diabetic women in comparison to non-diabetic women--A prospective study in Asian Indian mothers (CURES-35).

BACKGROUND AND OBJECTIVE: Diabetes can complicate pregnancy but it is not the major complication of pregnancy. Though prevalence of diabetes is alarmingly high among Indians there have been very few studies assessing the effect of diabetes on pregnancy outcomes, particularly comparing pre-gestational diabetes mellitus [PGDM] and gestational diabetes [GDM] with non-diabetic mothers. METHODS: Pregnant women attending the Dr. Mohan's Diabetes Specialities Centre, a tertiary care centre for diabetes in Chennai in southern India were selected for the study. PGDM and GDM were defined using standard criteria. Out of the 245 pregnant women with diabetes registered at the centre, follow up data was available for 225, which included 79 PGDM and 146 GDM subjects. Non-diabetic controls (n=30) were recruited from the ongoing population based study the Chennai Urban Rural Epidemiology Study (CURES). Details of outcome variables including abortions, mode of delivery, congenital anomalies and neonate's birth weight were documented. RESULTS: Women with PGDM had significantly higher fasting plasma glucose [p<0.001] and fructosamine [p<0.001] levels compared to GDM. Proportion of women who underwent abortions was 0% in non-diabetic controls, 10.1% in PGDM and 2.7% in GDM and the difference between PGDM and GDM was statistically significant [p = 0.04]. Prevalence of 'low birth weight' babies in the study groups were, 14.3% in non-diabetic mothers, 12.3% in PGDM and 8.2% in GDM. The prevalence of 'large babies' was higher in GDM [27.6%] and PGDM [19.2%] groups compared to non-diabetic controls [7.1%] but the differences reached statistical significance only in the GDM group [p = 0.04]. Prevalence of congenital anomalies was 0% among non-diabetic controls, 3.8% in PGDM and 1.4% in GDM but the differences did not reach statistical significance. A significant increase in frequency of abortions [trend chi square = 5.67, p = 0.017] and 'low birth weight' babies [trend chi square = 4.761,p = 0.029] was observed with increasing fructosamine levels in the diabetic mothers. CONCLUSION: Women with diabetes have worse pregnancy outcomes compared to non-diabetic mothers with and those with pre-gestational diabetes fare worse than those with gestational diabetes. The study emphasizes the fact that strict glycemic control is extremely important during pregnancy.

Adult↗

PubMed2000

Parathyroid hormone-related protein(1-34) in gestational fluids and release from human gestational tissues.

Parathyroid hormone-related protein (PTHrP) is present in fetal and gestational tissues, in which its proposed roles include stimulation of epithelial growth and differentiation, vasodilatation of the uteroplacental vasculature, relaxation of uterine muscle and stimulation of placental calcium transport. The aim of this study was to determine whether the release of PTHrP from gestational tissue explants was tissue specific. In addition, PTHrP concentrations were measured in maternal plasma, umbilical artery and vein plasma, and amniotic fluid from term, uncomplicated pregnancies before the onset of labour. PTHrP was detected in low concentrations in the mother, fetus and placental tissue. Amniotic fluid had ten times the PTHrP concentration compared with that in the maternal or fetal circulations. Using late pregnant human gestational tissues in an in vitro explant system, we found that amnion over placenta, choriodecidua, reflected amnion, and placenta released PTHrP into culture medium in progressively greater amounts over 24 h (P<0.05). This release was not associated with a loss of cell membrane integrity, as indicated by measurement of the intracellular enzyme, lactate dehydrogenase, in the incubation media. After 24 h incubation, the fetal membranes released significantly (P<0.05) greater amounts of PTHrP than did the placenta (placenta 3. 7+/-0.5 pmol PTHrP/g protein). Amnion over placenta released significantly more PTHrP (139.3+/- 43.1 pmol PTHrP/g protein) than did reflected amnion (29.0+/-8.3 pmol PTHrP/g protein) (P<0.05). This study unequivocally demonstrated that human gestational tissues release PTHrP and it was concluded that the main contributors to PTHrP in amniotic fluid were the human fetal membranes, particularly amnion over placenta. Fetal membrane-derived and amniotic fluid PTHrP are proposed to have stimulatory effects on epithelial growth and differentiation in fetal lung, gut, skin and hair follicles and paracrine effects on placental vascular tone and calcium transport.

Amnion↗

PubMedDate not supplied

Gestational changes in hamster adrenal cortex. II. Proliferative activity of adrenocortical cells in the course of gestation.

Proliferative activity of adrenocortical cells was determined in the course of hamster gestation. The highest adrenal gland weight was noted at day 5 of pregnancy, followed by a gradual decrease towards the end of gestation. As revealed by stereology, total number of adrenocortical cells increased notably at days 5 and 10 of pregnancy and was followed by a prompt drop to the value observed in the control group. In vitro 3H-thymidine incorporation per pair of adrenals increased slightly at days 5 and 10 of pregnancy and decreased at day 15. The highest DNA content was found in adrenals taken at day 10 of gestation. The number of mitoses per adrenal section also increased at days 5 and 10 and reached the control value at day 15 of pregnancy. After vincristine administration, mitoses were predominantly seen in glomerulosa and outer fasciculata zones. Thus in the course of hamster pregnancy, a marked increase in proliferative activity of adrenocortical cells occurs up to day 10 of gestation and is followed by a significant drop in proliferative activity in the final days of pregnancy.

Adrenal Cortex↗

PubMed1990

Eight-year school performance and growth of preterm, small for gestational age infants: a comparative study with subjects matched for birth weight or for gestational age.

Eight-year school performance and growth outcome are reported for three groups of preterm infants: one group that was small for gestational age (SGA; 36 infants) and two comparison groups that were appropriate in size for gestational age, one matched for birth weight and the other for gestational age. The subjects all had white parents whose mother tongue was English and were matched for gender, mother's height, mother's education, and father's socioeconomic status (Blishen Scale). A comparison peer group of term infants was also studied. The three preterm groups did not differ in school performance or physical growth, with the exception of head circumference, which was smaller in the SGA children. All preterm groups had growth measures, intellectual and visual-motor integration scores, reading and arithmetic grade levels, and behavior rating levels significantly inferior to those of the peer group. Receptive vocabulary scores and spelling grade levels did not differ between the preterm groups and the peer group. On multivariate analyses, mother's education was the primary predictor of academic grade levels for the preterm SGA group, and the only predictor when the disabled children were excluded from analyses. Preterm SGA children without disabilities had academic scores similar to those of their term peers, but their scores indicated more hyperactivity. Intrauterine growth retardation did not appear to impose a disadvantage on the preterm children in this study.

Alberta↗

PubMed1997

Omphalitis in term and preterm appropriate for gestational age and small for gestational age infants.

To determine whether there is a difference on the historical and clinical characteristics of omphalitis among term and preterm appropriate for gestational age (AGA) and small for gestational age (SGA) infants, we prospectively investigated 85 newborns with bacteriologically proved omphalitis. Study groups were based on gestational age and being SGA. Preterm AGA infants had significantly lower mean age and neutrophil counts. Risk factors such as septic delivery including unplanned home delivery, and bacterial spectrum were similar in the groups. Staphylococcus aureus and Escherichia coli were the most frequent micro-organisms. Mortality rates for the study groups were similar and overall case fatality rate was 13 per cent. Immunological immaturity of preterm newborns may explain the earlier occurrence age of omphalitis and lower absolute neutrophil count. The following features such as early-onset infection, septic delivery including unplanned home delivery and abnormal temperature may be considered as determinants of poor prognosis. However, further studies are needed.

Chi-Square Distribution↗

PubMed2003

Maternal and umbilical cord serum leptin concentrations in small-for-gestational-age and in appropriate-for-gestational-age neonates: a maternal, fetal, or placental contribution?

Leptin is secreted during pregnancy by the placenta and by the maternal and fetal adipose tissues. The leptin levels mainly reflect the amount of fat stored and thus are indicative of the energy balance, i.e., small-for-gestational-age (SGA) neonates represent the negative metabolic balance of in utero starved babies. We chose to compare maternal and umbilical cord leptin levels in pregnancies complicated by asymmetrical SGA versus those with appropriate-for-gestational-age (AGA) neonates as well as a model of multifetal growth concordant gestations in order to establish through the 'leptin link' the relative contributions of mother, fetus, and placenta to fetal weight. We found that the maternal leptin levels at delivery correlated poorly with the maternal weight gain/body mass index and with neonatal birth weight. Furthermore, the umbilical cord leptin levels correlated well with neonatal and placental weights in the AGA group but not in the SGA group. As in AGA singleton pregnancies, in multifetal uncomplicated pregnancies, the umbilical cord leptin levels correlated well with the birth weight of individuals, regardless of the status of the twin or triplet in the set. Thus, we speculated that in SGA neonates the birth weight represents the lean body weight and the low adipose tissue content (as opposed to the AGA neonates who have a substantial adipose tissue content) and, therefore, reflects mainly the basic placental contribution.

Adipose Tissue↗

PubMed1988

Intracranial hemorrhage in small-for-gestational-age neonates: comparison with weight-matched appropriate-for-gestational-age infants.

In a comparative study of 93 small-for-gestational-age (SGA) infants against 93 weight-matched, appropriate-for-gestational-age (AGA) neonates, the SGA group exhibited a significantly lower incidence of periventricular-intraventricular type intracranial hemorrhage (ICH) at the first ultrasound scan than did the AGA neonates (9/93 vs 21/93; p less than 0.02). This apparent advantage was no longer maintained in later scans of the first week (16/93 vs 27/93; NS), despite the fact that the SGA group were 4 weeks advanced in gestational age and had fewer respiratory problems than the AGA controls. It is prudent, therefore, to follow SGA infants closely for ICH by repeat ultrasound examinations even if the first scan is negative. Evaluation of the subgroup of SGA infants with ICH against the total SGA population revealed lower admission body temperature and Apgar scores, and higher incidence of asphyxia, resuscitation, and mortality. The above observations in SGA infants with ICH and the lack of a similar trend between the AGA infants with ICH and the total AGA population suggest that SGA status, hypothermia, and ICH are interrelated. Hypothermia, therefore, can be used as a convenient marker for the possibility of ICH in low birth weight SGA infants. The authors' data is consistent with the view that hypothermia and ICH are both the consequences of perinatal asphyxia in SGA infants and probably reflect the magnitude of stormy perinatal events.

Apgar Score↗

PubMed2002

Determinants of mild gestational hyperglycemia and gestational diabetes mellitus in a large dutch multiethnic cohort.

OBJECTIVE: The purpose of this study was to identify independent determinants of mild gestational hyperglycemia (MGH) and gestational diabetes mellitus (GDM) and to assess the correlation between fasting glucose and C-peptide levels among control, MGH, and GDM women. RESEARCH DESIGN AND METHODS: A total of 1,022 consecutive women were evaluated with a 1-h 50-g glucose challenge test (GCT) at between 16 and 33 weeks of gestation. Women with a capillary whole-blood glucose > or =7.8 mmol/l in the GCT underwent a 3-h 100-g oral glucose tolerance test (OGTT). On the basis of a positive GCT, the women with a positive OGTT were classified as GDM, whereas the women with a negative OGTT were classified as MGH. The following data were collected for all women: age, prepregnancy BMI, ethnicity, clinical and obstetric history, pregnancy outcome, and C-peptide level. RESULTS: A total of 813 women (79.6%) were normal, 138 (13.5%) had MGH, and 71 (6.9%) had GDM. There was a stepwise significant increase in mean fasting glucose (3.6 +/- 0.4, 3.9 +/- 0.4, and 4.7 +/- 0.7 mmol/l, respectively) and C-peptide level (0.60 [0.1-2.4], 0.86 [0.3-2.0], and 1.00 [0.5-1.6] nmol/l, respectively) among the three diagnostic groups. Maternal age, non-Caucasian ethnicity, and prepregnancy BMI were associated with GDM, whereas only maternal age and prepregnancy BMI were associated with MGH. A positive correlation between levels of fasting glucose and C-peptide was found in control women (r = 0.39 [95% CI 0.31-0.46]). A similar result was seen in MGH women (r = 0.38 [95% CI 0.23-0.52]), whereas the correlation between fasting glucose and C-peptide was nearly lost in GDM women (r = 0.14 [CI -0.09 to 0.36]). The fasting C-peptide-to-glucose ratio was reduced by 60% in GDM patients versus control subjects and MGH patients (0.41 +/- 0.25 vs. 0.70 +/- 0.20 and 0.73 +/- 0.23, P < 0.001). CONCLUSIONS: Of the well-known independent determinants of GDM, only maternal age and prepregnancy BMI were associated with MGH. It appears that additional factors promoting loss of beta-cell function distinguish MGH from GDM. One of these factors appears to be ethnicity.

Adult↗

PubMed1999

[The problems and outcome with newborns who are extremely low birth weight, appropriate for gestational age and small for gestational age].

UNLABELLED: The aim of this study is to evaluate the consequences of being extremely low birth weight (ELBW) under 1000 g at birth, small (SGA) or appropriate for gestational age (AGA). METHODOLOGY: A retrospective comparison of two cohorts of ELBW AGA (n = 47) and SGA (n = 38) infants, admitted to the Intensive Care Unite of State Maternity Hospital "Maĭchin Dom" from 01, 1995 to 06, 1998 is carried out. Infants with major congenital anomalies and those, who died in the first two hours of life, being extremely premature and unviable, are excluded. RESULTS AND CONCLUSIONS: The mean birth weight of the AGA group is 863 g, their mean gestational age is 26.6 weeks of gestation and of the SGA group--795 g and 29.6 weeks respectively. In the Sga C-section is preferred in 85%, vs only 34% in the AGA group. SGA babies are with two times greater survival rate (61%) then AGA (32%). The causes of death are similar. The AGA survivors have a greater rate of stage III-IV intraventricular hemorrhage, more prolonged need for ventilatory support (19 vs 12 days for SGA) and oxygen supplementation (37.5 vs 30.7 for the SGA), more difficulties with enteral feeding and their median hospital stay is somewhat longer (81.9 days), compared with those of the SGA (76.6 days). The two groups show a similar rate of respiratory distress syndrome, chronic lung disease, infections and neurological complications among the survivors.

Bulgaria↗

PubMed2002

Perinatal outcome in large-for-gestational-age infants. Is it influenced by gestational impaired glucose tolerance?

OBJECTIVE: To examine the relationship between the World Health Organization category of impaired glucose tolerance (IGT) (two-hour value of the 75-g oral glucose tolerance test at 8-10.9 mmol/L) and outcome in large-for-gestational age (LGA) infants to determine whether IGT affects perinatal morbidity in addition to affecting infant size. STUDY DESIGN: A retrospective study was performed on 461 LGA newborns (birth weight > 90th percentile) from singleton pregnancies delivering after 36 completed weeks in a 12-month period to determine the difference in perinatal outcome between nondiabetic pregnancies (n = 382) and pregnancies with diet-treated IGT (n = 79). RESULTS: The IGT group had significantly higher mean maternal age, prepregnancy weight and body mass index (BMI) but lower absolute and percent gestational weight gain and no difference in infant gestational age, birth weight, BMI, incidence of macrosomia (birth weight > or = 4,000 g) or obstetric complications. However, the IGT group had an increased incidence of Erb's palsy (OR 7.81, 95% CI 1.76-34.62), meconium aspiration syndrome (OR 5.29, 95% CI 1.27-22.02), phototherapy (OR 2.10, 95% CI 1.03-5.69), sepsis (OR 2.90, 95% CI 1.25-6.74) and shoulder dystocia (OR 5.64, 95% CI 1.06-29.89) after adjusting for confounding factors (maternal age and BMI, postdate pregnancy, mode of delivery and infant sex). CONCLUSION: Despite dietary treatment, maternal IGT is associated with increased perinatal morbidity independent of its effect on fetal size.

Adult↗

PubMed2003

Neurobehavioral assessment of appropriate for gestational and small for gestational age babies.

he present study was conducted to evaluate the neurobehaviour of term appropriate for gestational aland small for gestational age babies during the first two weeks of life in a tertiary care hospital. Forty eight appropriate and thirty small for gestation age babies were evaluated using Brazelton Neurobehavioural Assessment Scale on 3rd, 7th and 14th day of life. The behaviour of AGA babies is characterized by optimal performance in habituation, range of state, regulation of state and autonomic stability. The behavior is at low to mid-range in orientation and in motor clusters. All the behavior clusters showed improvement over first 14 days except for regulation of state which showed a lower performance on day 7 and 14. The behavior performance of SGA babies on day 3, compared to AGA babies, was lower in all the clusters except orientation where they performed much better. The percentage improvement of scores in SGA babies is higher than in AGA babies and by day 14 SGA babies are scoring higher than AGA babies in orientation, autonomic stability and regulation of state. The difference in the neurobehavior pattern of babies in relation to their intrauterine growth suggests need for appropriate care.

Apgar Score↗

PubMed2004

[Maternal serum lipid at 36-42 weeks' gestation and their relationship to newborn weight in pregnant women with gestational diabetes mellitus and type 1 and type 2 diabetes mellitus].

OBJECTIVE: To investigate the levels of serum lipid at 36 - 42 weeks' gestation and their relationship to newborn weight in pregnant women with gestational diabetes mellitus (GDM) and type 1 and type 2 diabetes mellitus (DM). METHODS: This study included 30 normal pregnant women, 40 patients with GDM, 30 patients with type 1 DM and 30 with type 2 DM. Subjects with complications including hypertension or thyreogenic diseases were excluded. Fasting serum triglyceride, total cholesterol, high density lipoprotein cholesterol and low density lipoprotein cholesterol were measured by enzymatic method. RESULTS: (1) Serum triglyceride levels in pregnant women with GDM, type 1 DM, type 2 DM and normal controls were (4.0 +/- 1.4) mmol/L, (2.9 +/- 0.8) mmol/L, (4.1 +/- 2.5) mmol/L and (2.7 +/- 0.9) mmol/L respectively; the total cholesterol levels were (6.5 +/- 3.0) mmol/L, (6.2 +/- 2.8) mmol/L, (6.4 +/- 3.2) mmol/L and (6.0 +/- 3.0) mmol/L respectively; low density lipoprotein cholesterol levels were (3.2 +/- 1.3) mmol/L, (3.2 +/- 1.3) mmol/L, (3.3 +/- 1.1) mmol/L and (3.2 +/- 1.0) mmol/L respectively; high density lipoprotein cholesterol levels were (1.6 +/- 0.5) mmol/L, (1.4 +/- 0.5) mmol/L, (1.5 +/- 0.4) mmol/L and (1.6 +/- 0.4) mmol/L respectively; the newborn weights were (4108 +/- 544) g, (3323 +/- 457) g, (4111 +/- 263) g, and (3463 +/- 516) g respectively. Triglyceride levels in pregnant women with GDM and type 2 DM were significantly higher than in normal controls and type 1 DM patients (P < 0.01). (2) Triglyceride levels correlated with birth weights independently (r = 0.39, P < 0.01). CONCLUSIONS: Triglyceride levels at 36-42 weeks' gestation were elevated in pregnant women with GDM and type 2 DM, suggesting that they might have more obvious insulin resistance. In pregnant women with DM, a positive and significant correlation was found between triglyceride levels and newborn weights.

Adult↗

PubMed2007

Gestational diabetes mellitus: fetal liver length measurements between 21and 24 weeks' gestation.

PURPOSE: To evaluate sonographic measurements of the fetal liver, fetal abdominal fat layer, interventricular septum, and Wharton's jelly area between 21 and 24 weeks' gestation in women with gestational diabetes mellitus (GDM). METHODS: A total of 123 consecutive healthy pregnant women underwent sonographic examination at 21-24 weeks' gestational age. The measurements included fetal biometry, detailed anomaly scan, and fetal body composition measurements (subcutaneous fat, liver size, cardiac muscle thickness, and Wharton's jelly area). GDM was confirmed by way of a 75-g oral glucose tolerance test using World Health Organization criteria within 1 week of the examination. RESULTS: Nineteen (15.4%) women were diagnosed with GDM, while 104 (84.6%) women were without GDM. The mean fetal liver length was 36 mm (95% CI 32-37) in women with GDM and 31 mm (95% CI 30-33) in women without GDM (p < 0.01). Liver enlargement was related to maternal fasting glucose levels and not 2-hour postprandial levels. There was no significant difference in the fetal biometric and other fetal body measurements between the 2 groups. CONCLUSIONS: The findings of this study suggest that midtrimester fetal liver length appears to be longer in GDM than in normal pregnancies. However, the fetal abdominal fat layer, interventricular septum, and Wharton's jelly were not affected. Nevertheless, further, larger randomized studies are required to confirm these findings.

Adipose Tissue↗