title: Fetal limb soft tissue assessment for prediction of birth weight and umbilical cord blood analytes in gestational diabetes.
abstract: OBJECTIVE
  To evaluate the value of third trimester ultrasound (estimated fetal weight, cheek-to-cheek diameter, sectional Wharton's jelly area, sectional areas and fractional volumes in extremities) to predict birth weight and cord biochemical markers at birth (leptin, insulin, c-peptide, IGF1, erythropoietin and ferritin) in diabetic pregnancies.
  
  
  METHODS
  Prospective study in 49 patients with gestational diabetes. An ultrasound was performed between 32 and 34 weeks. Clinical data were collected, and a blood sample was obtained from cord after birth. ROC curve models were evaluated for 75(th) and 90(th) birth weight percentile. Univariate and multivariate models were used to assess the association between ultrasound and neonatal outcomes.
  
  
  RESULTS
  Sectional areas and fractional volumes showed significant differences and highest AUC values for predicting birth weight. A significant association was found for extremities measurements with total birth weight and its percentile. The only marker which showed a significant association to estimated fetal weight was erythropoietin. Sectional areas and fractional volumes related to cord leptin, erythropoietin, insulin and c-peptide.
  
  
  CONCLUSIONS
  Sectional areas and fractional volumes improve the predictive value of estimated fetal weight in diabetic pregnancies. They also show a predictive association to biochemical changes in cord (leptin, insulin and erythropoietin) related to increased adiposity and risk of fetal hypoxia. © 2015 John Wiley & Sons, Ltd.
authors.affiliation: High-Risk Pregnancy Unit. Obstetrics and Gynecology Department, Hospital Universitario Quiron Madrid, Pozuelo de Alarcon, Madrid, Spain.
authors.forename: Jose
authors.identifier: http://orcid.org/0000-0003-1013-9914
authors.initials: J
authors.lastname: Garcia-Flores
authors.affiliation: High-Risk Pregnancy Unit. Obstetrics and Gynecology Department, Hospital Universitario Quiron Madrid, Pozuelo de Alarcon, Madrid, Spain.
authors.forename: Mireia
authors.initials: M
authors.lastname: Cruceyra
authors.affiliation: High-Risk Pregnancy Unit. Obstetrics and Gynecology Department, Hospital Universitario Quiron Madrid, Pozuelo de Alarcon, Madrid, Spain.
authors.forename: Marina
authors.initials: M
authors.lastname: Cañamares
authors.affiliation: High-Risk Pregnancy Unit. Obstetrics and Gynecology Department, Hospital Universitario Quiron Madrid, Pozuelo de Alarcon, Madrid, Spain.
authors.forename: Ainhoa
authors.initials: A
authors.lastname: Garicano
authors.affiliation: High-Risk Pregnancy Unit. Obstetrics and Gynecology Department, Hospital Universitario Quiron Madrid, Pozuelo de Alarcon, Madrid, Spain.
authors.forename: Olga
authors.initials: O
authors.lastname: Nieto
authors.affiliation: Clinical Analysis Department, Hospital Universitario Quiron Madrid, Pozuelo de Alarcon, Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Lopez
authors.affiliation: Neonatology Department, Hospital Universitario Quiron Madrid, Pozuelo de Alarcon, Madrid, Spain.
authors.forename: Izaskun
authors.initials: I
authors.lastname: Dorronsoro
authors.affiliation: High-Risk Pregnancy Unit. Obstetrics and Gynecology Department, Hospital Universitario Quiron Madrid, Pozuelo de Alarcon, Madrid, Spain.
authors.forename: Ines
authors.initials: I
authors.lastname: Tamarit
authors.affiliation: High-Risk Pregnancy Unit. Obstetrics and Gynecology Department, Hospital Universitario Quiron Madrid, Pozuelo de Alarcon, Madrid, Spain.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Sainz De La Cuesta
mesh_terms: D000328:Adult; D001724:Birth Weight; D050218:Body Fat Distribution / Q000379:methods*; D002096:C-Peptide / Q000097:blood; D016640:Diabetes, Gestational / Q000000981:diagnostic imaging*; D004921:Erythropoietin / Q000097:blood; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D006801:Humans; D007328:Insulin / Q000097:blood; D020738:Leptin / Q000097:blood; D011247:Pregnancy; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal / Q000379:methods*
chemical_list: D002096:C-Peptide; D007328:Insulin; D020738:Leptin; D004921:Erythropoietin