Large-for-gestational-age infants of type 1 diabetic mothers: an effect of preprandial hyperglycemia?
OBJECTIVE
To determine how the frequency, timing and magnitude of hyperglycemia are associated with large-for-gestational-age (LGA) infants in pregnancies complicated by type 1 diabetes.


METHODS
Charts from pregnant women with type 1 diabetes (n = 70) were reviewed. Indices of maternal glycemic control were determined for seven gestational periods (weeks 7-10, 11-15, 16-19, 20-24, 25-28, 29-32 and 33-38) and compared between women who delivered LGA infants and appropriate-for-gestational-age (AGA) infants.


RESULTS
Of the 70 pregnancies, 57% of the infants were LGA (4.3 +/- 0.4 kg) and 43% were AGA (3.2 +/- 0.4 kg). Total maternal weight gain and rate of weight gain were significantly higher in mothers with LGA infants. The glycemic variables associated with an LGA infant were percentage of preprandial values above target for weeks 11-15, 25-28 and 29-32, and percentage of all values above target for weeks 33-38. For the entire pregnancy, the strongest predictors of an LGA infant were percentage of preprandial blood glucose values above target during weeks 29-32 and maternal weight gain.


CONCLUSIONS
In pregnant women with type 1 diabetes, frequent episodes of preprandial hyperglycemia in the third trimester significantly impact the development of LGA infants.
Aschwald
Camille L
CL
Department of Nutrition and Dietetics, Saint Louis University, St. Louis, Missouri, USA.
Catanzaro
Rosemary B
RB
Weiss
Edward P
EP
Gavard
Jeffrey A
JA
Steitz
Karen A
KA
Mostello
Dorothea J
DJ
D000328:Adult; D019540:Area Under Curve; D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism*; D004435:Eating; D005260:Female; D005865:Gestational Age; D006801:Humans; D006943:Hyperglycemia / Q000378:metabolism*; D007231:Infant, Newborn; D008297:Male; D008499:Medical Records; D011237:Predictive Value of Tests; D011247:Pregnancy
D001786:Blood Glucose