What degree of maternal metabolic control in women with type 1 diabetes is associated with normal body size and proportions in full-term infants?
OBJECTIVE
To assess what degree of maternal metabolic control in women with type 1 diabetes is associated with normal fetal growth and results in normal neonatal body proportions in a group of full-term infants.


METHODS
We investigated the anthropometric characteristics of 98 full-term singleton infants born to 98 Caucasian women with type 1 diabetes enrolled within 12 weeks of gestation. The type 1 diabetic mother-infant pairs were divided into three groups on the basis of the daily glucose levels reached during the second and third trimesters of pregnancy (group 1: 37 mother-infant pairs with an average daily glucose level during the second and third trimesters of < or =95 mg/dl; group 2: 37 mother-infant pairs with an average daily glucose level during the second trimester of >95 mg/dl and during the third trimester of < or =95 mg/dl; group 3: 24 mother-infant pairs with an average daily glucose level during the second and third trimesters of >95 mg/dl; control group: 1,415 Caucasian mother-infant pairs with full-term singleton pregnancies and normal glucose challenge test screened for gestational diabetes.


RESULTS
Infants of diabetic mothers in group 1 were similar to those of the control group in birth weight and in other anthropometric parameters. In contrast, offspring of diabetic mothers of groups 2 and 3 showed an increased incidence of large-for-gestational-age infants, significantly greater means of ponderal index and thoracic circumferences, and significantly smaller cranial/thoracic circumference ratios with respect to the control group.


CONCLUSIONS
The results of our study suggest that, in diabetic pregnancies, only overall daily glucose values < or =95 mg/dl throughout the second and third trimesters can avoid alterations in fetal growth.
Mello
G
G
Second Obstetric and Gynecologic Clinic, Institute of Obstetrics and Gynecology, University of Florence, Italy. mellog@unifi.it
Parretti
E
E
Mecacci
F
F
La Torre
P
P
Cioni
R
R
Cianciulli
D
D
Scarselli
G
G
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism; D001824:Body Constitution; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000503:physiopathology; D005260:Female; D005320:Fetal Macrosomia; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007558:Italy; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D011254:Pregnancy in Diabetics / Q000097:blood* / Q000503:physiopathology; D044465:White People
D001786:Blood Glucose