Asymmetric large-for-gestational-age infants of type 1 diabetic women: morbidity and abdominal growth.
We sought to examine neonatal morbidity in four groups of offspring (asymmetric large for gestational age [LGA], symmetric LGA, asymmetric non-LGA, symmetric non-LGA) exposed in utero to maternal type 1 diabetes, and the association between rate of fetal abdominal circumference growth and asymmetric LGA. We performed a secondary analysis of 302 singleton pregnancies. Neonatal morbidity (respiratory distress syndrome, polycythemia, hypoglycemia, hyperbilirubinemia, acidosis, and composite morbidity [any of the five]) was assessed. Serial ultrasound examinations after 20 weeks' gestation were available for 35 fetuses. Logistic regression and general linear mixed modeling were used for analysis. Asymmetric LGA infants had 3.5-, 2.2-, and 3.2-fold greater odds of hypoglycemia, hyperbilirubinemia, and composite morbidity, respectively, compared with symmetric non-LGA infants. The rate of growth of the abdominal circumference in asymmetric LGA infants (1.11 cm/wk) was greater than for both the symmetric LGA infants (0.87 cm/wk, P = 0.09) and the symmetric non-LGA infants (0.87 cm/wk, P = 0.03). Asymmetric LGA infants are at higher risk for morbidity than symmetric LGA and non-LGA infants. Intrauterine growth rate of the abdominal circumference may potentially be used as a marker to identify the asymmetric LGA and thereby aid in the identification of newborns at greatest risk for perinatal complications.
Bollepalli
Sureka
S
Division of Endocrinology, Cincinnati Children's Hospital Medical Center and University of Cincinnati School of Medicine, Cincinnati, OH 45208, USA. surekabollepalli@yahoo.com
Dolan
Lawrence M
LM
Miodovnik
Menachem
M
Feghali
Maisa
M
Khoury
Jane C
JC
D001724:Birth Weight / Q000502:physiology; D000013:Congenital Abnormalities / Q000175:diagnosis / Q000235:genetics / Q000401:mortality / Q000503:physiopathology / Q000517:prevention & control; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology / Q000235:genetics* / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D018743:Perinatal Care; D054238:Perinatal Mortality; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D011254:Pregnancy in Diabetics / Q000453:epidemiology / Q000235:genetics* / Q000503:physiopathology / Q000628:therapy; D011295:Prenatal Care; D012307:Risk Factors; D016216:Ultrasonography, Prenatal