%0 Journal Article
%T Fetal size monitoring in women with gestational diabetes and normal glucose tolerance.
%A Beunen K
%A Van den Abbeele F
%A Van Crombrugge P
%A Verhaeghe J
%A Vandeginste S
%A Verlaenen H
%A Maes T
%A Dufraimont E
%A Roggen N
%A De Block C
%A Jacquemyn Y
%A Mekahli F
%A De Clippel K
%A Van den Bruel A
%A Loccufier A
%A Laenen A
%A Devlieger R
%A Mathieu C
%A Benhalima K
%J Acta Diabetol
%V 0
%N 0
%D 2024 Jul 20
%M 39031189
%F 4.087
%R 10.1007/s00592-024-02330-0
%X <B>OBJECTIVE: </B>To monitor fetal size and identify predictors for birthweight in women with gestational diabetes (GDM) and normal glucose tolerance (NGT).<BR><B>METHODS: </B>Cohort study of 1843 women universally screened for GDM, with routine ultrasounds each trimester. Women with GDM and NGT were categorized in subgroups by birthweight centile.<BR><B>RESULTS: </B>Of the total cohort, 231 (12.5%) women were diagnosed with GDM. Fetal size, incidence of large-for-gestational age (LGA: 12.3% of GDM vs. 12.9% of NGT, p = 0.822) and small-for-gestational age (SGA) neonates (4.8% of GDM vs. 5.1% of NGT, p = 0.886) were similar between GDM and NGT. GDM women with LGA neonates were more insulin resistant at baseline and had more often estimated fetal weight (EFW) ≥ P90 on the 28-33 weeks ultrasound (p = 0.033) than those with AGA (appropriate-for-gestational age) neonates. Compared to NGT women with AGA neonates, those with LGA neonates were more often obese and multiparous, had higher fasting glycemia, a worse lipid profile, and higher insulin resistance between 24 -28 weeks, with more often excessive gestational weight gain. On the 28-33 weeks ultrasound, abdominal circumference ≥ P95 had a high positive predictive value for LGA neonates in GDM (100%), whereas, in both GDM and NGT, EFW ≥ P90 and ≤ P10 had a high negative predictive value for LGA and SGA neonates (> 88%), respectively.<BR><B>CONCLUSIONS: </B>There were no differences in fetal size throughout pregnancy nor in LGA incidence between GDM and NGT women. EFW centile at 28-33 weeks correlated well with birthweight. This indicates that GDM treatment is effective and targeted ultrasound follow-up is useful. TRIAL REGISTRATION CLINICALTRIALS.GOV: NCT02036619. Registration date: January 15, 2014. https://clinicaltrials.gov/ct2/show/NCT02036619 .