Factors predictive of macrosomia in pregnancies with a positive oral glucose challenge test: importance of fasting plasma glucose.
OBJECTIVE
The study aimed to determine the factors associated with fetal macrosomia following a positive oral glucose challenge test (OGCT).


METHODS
In this retrospective single-centre study of 1268 pregnancies with positive 50-g OGCTs (plasma glucose≥130mg/dL, or 7.2mmol/L), gestational diabetes mellitus (GDM) was defined as fasting plasma glucose (FPG)≥95mg/dL (5.3mmol/L) and/or postprandial glucose (PPG)≥120mg/dL (6.7mmol/L).


RESULTS
In GDM pregnancies, the odds ratios adjusted for confounders (age, BMI, ethnicity, parity and weight gain) were 2.02 for macrosomia (Z score≥1.28) and 2.62 for severe macrosomia (Z score≥1.88). For each 10-mg/dL increase in FPG, the mean birth-weight increase was 60g. Macrosomia risk did not differ between GDM patients with normal FPG (<95mg/dL, or 5.3mmol/L) and non-diabetics, but increased significantly in cases of FPG≥95mg/dL and regardless of the level of PPG.


CONCLUSIONS
In our study population, birth-weight and macrosomia risk were strongly correlated with FPG, suggesting that it is a simple and efficient marker for the risk of macrosomia.
Service de gynécologie-obstétrique, hôpital Louis-Mourier, hôpitaux universitaires, Paris Nord Val-de-Seine et université Paris-Diderot, HUPNVS, AP-HP, 178, rue des Renouillers, 92701 Colombes cedex, France.
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Legardeur
Service de gynécologie-obstétrique, hôpital Louis-Mourier, hôpitaux universitaires, Paris Nord Val-de-Seine et université Paris-Diderot, HUPNVS, AP-HP, 178, rue des Renouillers, 92701 Colombes cedex, France.
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Girard
Unité de recherche clinique en économie de la santé d'Île-de-France, 228, rue du Faubourg-Saint-Honoré, 75010 Paris, France.
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Journy
Service de gynécologie-obstétrique, hôpital Louis-Mourier, hôpitaux universitaires, Paris Nord Val-de-Seine et université Paris-Diderot, HUPNVS, AP-HP, 178, rue des Renouillers, 92701 Colombes cedex, France.
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Ressencourt
Unité de recherche clinique en économie de la santé d'Île-de-France, 228, rue du Faubourg-Saint-Honoré, 75010 Paris, France.
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Durand-Zaleski
Service de gynécologie-obstétrique, hôpital Louis-Mourier, hôpitaux universitaires, Paris Nord Val-de-Seine et université Paris-Diderot, HUPNVS, AP-HP, 178, rue des Renouillers, 92701 Colombes cedex, France. Electronic address: laurent.mandelbrot@lmr.aphp.fr.
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Mandelbrot
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D016640:Diabetes, Gestational / Q000097:blood* / Q000175:diagnosis; D005215:Fasting; D005260:Female; D005320:Fetal Macrosomia / Q000097:blood* / Q000175:diagnosis*; D005602:France; D005951:Glucose Tolerance Test; D006801:Humans; D007231:Infant, Newborn; D016017:Odds Ratio; D010298:Parity; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D011247:Pregnancy; D012189:Retrospective Studies; D015430:Weight Gain
D015415:Biomarkers; D001786:Blood Glucose
Gestational diabetes mellitus; Macrosomia; Pregnancy; Screening