[Gestational diabetes under clinical conditions in aspired normoglycemia: investigation for correlation of blood glucose daily profiles and fetometric ultrasound parameters].
BACKGROUND
One of the therapeutic aims in gestational diabetes (GDM) is to prevent the development of fetal hypertrophy by adaptation of maternal glycemic control. Relating to this context, maternal blood glucose daily profiles and fetal biometry ultrasound parameters were analysed for a possible correlation. A special focus was given to the question as to whether a latency period exists for this possible connection.


METHODS
152 pregnancies affected by GDM, without fetal malformations or aneuploidies, were enrolled. Altogether, 746 ultrasound examinations consisting of 7 fetometric parameters each and 1 288 blood glucose daily profiles originating from the 20 (th) to 40 (th) gestational week were systematically investigated for interrelation by correlation and multiple regression analysis.


RESULTS
No robust, constant correlation between the analysed parameters could be observed. However, marked differences between latency periods were noticed. Blood glucose parameters, which revealed significant regressions with fetal abdominal circumference, had an average time lag of 6.2 +/- 2.5 weeks, whereas the latency period for head circumference averaged 2.4 +/- 1.2 weeks. The overall small-for-gestational-age (SGA) rate was 20 %, pregnant women with a body mass index > 30 kg / m (2) revealed the highest rate of 28 %.


CONCLUSIONS
Therapeutic intervention depending on sonographically detected hypertrophy must be considered as being delayed. The currently valid therapeutic criteria including intended normoglycemia and regular fetometric ultrasound controls cannot prevent markedly high SGA rates, especially among obese women, in adequately treated GDM.
Kessel
S
S
Abteilung I für Geburtshilfe, Pränatalmedizin und allg. Gynäkologie, Frauenklinik der Med. Hochschule Hannover, Carl-Neuberg-Str. 1, 30625 Hannover.
Staboulidou
I
I
Oehler
K
K
Hillemanns
P
P
Scharf
A
A
Günter
H-H
HH
D000328:Adult; D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D016640:Diabetes, Gestational / Q000097:blood* / Q000000981:diagnostic imaging / Q000628:therapy; D005260:Female; D005320:Fetal Macrosomia / Q000097:blood* / Q000000981:diagnostic imaging; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D016216:Ultrasonography, Prenatal
D001786:Blood Glucose