title: Using estimated fetal weight from ultrasonography at 18 to 22 weeks to predict gestational diabetes mellitus and newborn macrosomia.
abstract: OBJECTIVE
  To determine if fetal macrosomia in the second trimester predicts the onset of gestational diabetes mellitus (GDM) or large for gestational age (LGA) birth weight.
  
  
  METHODS
  We performed a case-control study using data from the Diabetes in Pregnancy Clinic in our tertiary care hospital. Cases were women with GDM requiring insulin (n = 65) or controlled with diet (n = 65). Control subjects were women who screened negative for GDM at 24 to 28 weeks' gestation (n = 131). Estimated fetal weight (EFW) was determined by ultrasound at 18 to 22 weeks.
  
  
  RESULTS
  Estimated fetal weight that was one standard deviation (70 g) higher at 18 to 22 weeks was not associated with subsequent GDM (adjusted OR [aOR] 1.00, 95% confidence intervals 0.61 to 1.66), but was associated with a 231 g (95% CI 128 g to 334 g) increase in birth weight and increased odds of LGA (aOR 4.02, 95% CI 1.76 to 9.19) after adjusting for gestational age at the time of estimating fetal weight, maternal age, parity, BMI and GDM treatment.
  
  
  CONCLUSIONS
  EFW at 18 to 22 weeks did not predict the onset of GDM, but did predict LGA.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Toronto, Toronto ON.
authors.forename: Pamela
authors.initials: P
authors.lastname: Liao
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto ON.
authors.forename: Alison L
authors.initials: AL
authors.lastname: Park
authors.affiliation: Department of Obstetrics and Gynaecology, University of Toronto, Toronto ON.
authors.forename: Howard
authors.initials: H
authors.lastname: Berger
authors.affiliation: Departments of Medicine, Obstetrics and Gynecology, and Health Policy Management and Evaluation, St. Michael's Hospital, University of Toronto, Toronto ON.
authors.forename: Joel G
authors.initials: JG
authors.lastname: Ray
mesh_terms: D016022:Case-Control Studies; D016640:Diabetes, Gestational / Q000175:diagnosis*; D005260:Female; D005320:Fetal Macrosomia / Q000175:diagnosis / Q000000981:diagnostic imaging*; D020567:Fetal Weight / Q000502:physiology*; D006801:Humans; D016015:Logistic Models; D011247:Pregnancy; D016216:Ultrasonography, Prenatal / Q000379:methods*
keywords: birth weight; estimated fetal weight; gestational diabetes mellitus; large for gestational age birth weight; macrosomia; ultrasound