Increased macrosomia and perinatal morbidity independent of maternal obesity and advanced age in Korean women with GDM.
OBJECTIVE
To examine the impact of gestational diabetes mellitus(GDM) on perinatal outcome in a setting where influences of maternal age and obesity would be minimal.


METHODS
A case-control study was done to compare the outcome of pregnancy in 65 women with GDM and 153 women with normal carbohydrate metabolism matched for age, height, and prepregnancy weight.


RESULTS
The frequencies of preeclampsia and primary cesarean sections were higher and delivery was earlier in pregnancies complicated by GDM. Birth weight, symmetry index, and chest circumference were greater, and macrosomia and need for phototherapy were more common in offspring of mothers with GDM. Cord-serum C-peptide and insulin concentrations were higher in the infants of mothers with GDM and were strongly correlated with birth weight and symmetry index. However, maternal age, prepregnancy weight, and prepregnancy BMI were not correlated with birth weight. Postprandial glucose levels during the first 2 weeks after diagnosis of GDM had associations with the infants' birth weight, symmetry index, and cord insulin concentration in the diet-treated patients with GDM.


CONCLUSIONS
Antepartum maternal glucose metabolism was significantly associated with fetal hyperinsulinemia and excessive fetal growth in relatively nonobese Korean women. These findings support a direct role for metabolic factors in the adverse outcomes in pregnancies complicated by GDM.
Jang
H C
HC
Department of Medicine, Samsung Cheil Hospital, Seoul, Korea. janghak@samsung.co.kr
Cho
N H
NH
Min
Y K
YK
Han
I K
IK
Jung
K B
KB
Metzger
B E
BE
D000328:Adult; D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D001835:Body Weight; D002096:C-Peptide / Q000097:blood; D016022:Case-Control Studies; D002585:Cesarean Section / Q000706:statistics & numerical data; D016640:Diabetes, Gestational; D005260:Female; D005312:Fetal Blood; D005320:Fetal Macrosomia / Q000453:epidemiology*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000453:epidemiology / Q000628:therapy; D007723:Korea; D008423:Maternal Age; D009017:Morbidity; D009765:Obesity; D010298:Parity; D010789:Phototherapy; D011247:Pregnancy; D011248:Pregnancy Complications; D011254:Pregnancy in Diabetics; D012044:Regression Analysis
D001786:Blood Glucose; D002096:C-Peptide