title: Risk factors associated with altered fetal growth in patients with pregestational diabetes mellitus.
abstract: OBJECTIVE
  To assess the risk factors for abnormal fetal growth in patients with pregestational diabetic mellitus (DM).
  
  
  METHODS
  A retrospective study was performed in 336 patients with pregestational DM. Small-for-gestational-age (SGA) and large-for-gestational-age (LGA) infants were defined as newborns with birth weights < 10th percentile and > 90th percentile, respectively. Logistic regression analysis was performed to identify risk factors for SGA and LGA.
  
  
  RESULTS
  Multivariate analysis of the patients with pregestational DM revealed a significant difference between patients who delivered SGA and appropriate-for-gestational-age (AGA) infants in terms of retinopathy (OR = 5.73, 95%CI = 1.39-23.59) and hemoglobin A1C (HbA1C) before delivery (OR = 0.80, 95%CI = 0.68 - 0.94, with a 0.1% increase in DCCT unit). Multivariate analysis revealed a significant difference between patients who delivered LGA and AGA infants in terms of primipara (OR = 3.40, 95%CI = 1.47-7.87) and HbA1C before delivery (OR = 1.14, 95%CI = 1.07-1.21, with a 0.1% increase in DCCT unit).
  
  
  CONCLUSIONS
  HbA1C before delivery influenced both SGA and LGA infants in patients with pregestational DM. Tight glycemic control might be harmful to fetal growth in pregestational diabetic patients, especially when complicated with retinopathy.
authors: Department of Obstetrics and Gynecology, Tokyo Women's Medical University, Tokyo, Japan. eeyore181479@yahoo.co.jp
authors: Eriko
authors: E
authors: Kanda
authors: Yoshio
authors: Y
authors: Matsuda
authors: Yasuo
authors: Y
authors: Makino
authors: Hideo
authors: H
authors: Matsui
mesh_terms: D000328:Adult; D016640:Diabetes, Gestational / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D047109:Fetal Development / Q000502:physiology; D005317:Fetal Growth Retardation / Q000453:epidemiology / Q000209:etiology*; D005320:Fetal Macrosomia / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007233:Infant, Postmature; D007236:Infant, Small for Gestational Age; D011236:Prediabetic State / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology*; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors