Is the early growth delay in the diabetic pregnancy accompanied by a delay in placental development?
We have previously shown that some fetuses in early diabetic pregnancy judged by the crown-rump length are smaller than expected from the menstrual history. Nine out of 26 fetuses in the present study were significantly (6 to 17 days) smaller than normal, and at birth they weighed 300 g less than the remainder. To examine whether this early somatic growth delay was accompanied by a delay in placental development, we correlated plasma levels of human placental lactogen (HPL) to menstrual age and growth delay. Multiple regression analysis showed that inclusion of the early growth delay as an explanatory variable significantly improved the correlation. The best correlation was achieved when menstrual ages were corrected by 90% of the early growth delay, suggesting that the somatic growth delay is accompanied by a similar delay in placental development. We recommend that every diabetic woman should undergo an ultrasound examination in early pregnancy, with determination of fetal size, and that management throughout pregnancy should be guided by the ultrasound age rather than that calculated from the first day of the last menstrual period.
D005314:Embryonic and Fetal Development; D005260:Female; D006801:Humans; D010920:Placenta / Q000503:physiopathology*; D010928:Placental Lactogen / Q000097:blood; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011254:Pregnancy in Diabetics / Q000097:blood / Q000503:physiopathology*; D014463:Ultrasonography
D010928:Placental Lactogen