title: Effect of different maternal metabolic characteristics on fetal growth in women with gestational diabetes mellitus.
abstract: BACKGROUND
  Fetal growth in diabetic pregnancies is a complex process and probably abnormalities in other metabolic pathways such as protein and lipid, as well as carbohydrate are responsible for delivering of macrosomic newborn.
  
  
  OBJECTIVE
  The purpose of this study was to investigate the association between fetal growth and different maternal metabolic parameters in women with gestational diabetes mellitus (GDM) in comparison to control group.
  
  
  METHODS
  This was a prospective cohort study conducted between March 2011 and May 2012, on 112 pregnant women with GDM and 159 healthy pregnant women. In order to determine of lipids or lipoproteins changes during pregnancy and to investigate any possible effects on fetal growth, lipid components, glucose and insulin levels were obtained in maternal serum three times in third trimester.
  
  
  RESULTS
  Maternal serum glucose, total cholesterol (TC), low and high density lipoprotein (LDL-c, HDL-c) levels did not show any significant difference between two groups. While insulin, homeostasis model assessment-insulin resistance (HOMA-IR) and triglyceride (TG) values were detected to be significantly higher in the GDM cases especially after 32 weeks of gestation (p<0.001). After adjustment for confounding variables, maternal hypertriglyceridemia remained as a significant risk factor for delivering large for gestational age (LGA) newborns (p=0.04); and according to spearman test the increase of TG level was correlated with increase of insulin resistance and HOMA-IR (p<0.001, CI: 0.312).
  
  
  CONCLUSIONS
  Due to positive correlation of hypertriglyceridemia and hyperinsulinemia with newborn weight, it is possible to assume that elevated TGs levels in GDM cases is a reflection of variation in maternal insulin levels.
authors.affiliation: Department of Obstetrics and Gynecology, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Laleh
authors.initials: L
authors.lastname: Eslamian
authors.affiliation: Department of Obstetrics and Gynecology, Lorestan University of Medical Sciences, Khoramabad, Iran.
authors.forename: Soheila
authors.initials: S
authors.lastname: Akbari
authors.affiliation: Department of Obstetrics and Gynecology, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Vajihe
authors.initials: V
authors.lastname: Marsoosi
authors.affiliation: Department of Obstetrics and Gynecology, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Jamal
keywords: Gestational diabetes mellitus; Lipid; Macrosomia