Relationship of neonatal body composition to maternal glucose control in women with gestational diabetes mellitus.
OBJECTIVE
To determine whether neonatal fat mass, which may be a better estimate of fetal overgrowth, is correlated with maternal fasting, preprandial and/or postprandial glucose values in women with gestational diabetes mellitus (GDM).


METHODS
Women with GDM and no other medical or obstetric problems, and their infants, were the subjects of this study. Portable reflectance meters were used by all participants for self-monitoring of blood glucose levels. Average fasting, preprandial, 2-h postprandial and bedtime glucose values were determined for each subject. Neonatal body composition was obtained by total body electric conductivity and/or anthropometric measurements within 48 h after delivery.


RESULTS
Eighteen women with their infants participated in this study. The age (mean +/- SD) of the mothers was 28.0 +/- 5.7 years. Nine were treated with diet and nine with diet and insulin. An average of 40 fasting (84 +/- 13 mg/dl), 50 preprandial (87 +/- 14 mg/dl), 80 2-h postprandial (106 +/- 19 mg/dl) and 17 bedtime (104 +/- 19 mg/dl) glucose values were obtained from each subject. The average gestational age of the infants at birth was 38.3 +/- 1.3 weeks with a mean weight of 3,356 +/- 526 g. Three infants were > 4 kg and seven infants were > 90th centile for gestational age. The strongest correlation with neonatal fat mass was maternal fasting glucose level (r = 0.71, p < 0.01). Neonatal fat mass was not found to be significantly correlated with any other mean glucose value. Additionally, the infant's per cent body fat (r = 0.71, p < 0.01), sum of skinfold thicknesses (r = 0.70, p < 0.01), fat-free mass (r = 0.50, p < 0.05), and weight (r = 0.61, p < 0.01) were also found to be correlated with maternal fasting glucose level. No other maternal glucose measurements were correlated with either birth weight or estimates of fat free mass.


CONCLUSIONS
Maternal fasting glucose levels correlated best with neonatal fat mass and other estimates of neonatal body composition.
Uvena-Celebrezze
J
J
Department of Reproductive Biology, Case Western Reserve University at MetroHealth Medical Center, Cleveland, Ohio 44109, USA.
Fung
C
C
Thomas
A J
AJ
Hoty
A
A
Huston-Presley
L
L
Amini
S B
SB
Catalano
P M
PM
D000328:Adult; D001724:Birth Weight / Q000502:physiology*; D015190:Blood Glucose Self-Monitoring; D001823:Body Composition / Q000502:physiology*; D016640:Diabetes, Gestational / Q000097:blood* / Q000503:physiopathology / Q000628:therapy; D003927:Diet, Diabetic; D005215:Fasting; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007231:Infant, Newborn / Q000254:growth & development*; D007328:Insulin / Q000627:therapeutic use; D016014:Linear Models; D019518:Postprandial Period; D011247:Pregnancy; D011256:Pregnancy Outcome; D012044:Regression Analysis; D013997:Time Factors
D007004:Hypoglycemic Agents; D007328:Insulin