title: In women with gestational diabetes mellitus factors influencing growth have a larger effect on placental weight than on birth weight.
abstract: OBJECTIVE
  Excessive fetal and placental growth are very common in diabetic pregnancy. We aimed to analyze in women with gestational diabetes mellitus (GDM) the association with birth weight (BW), placental weight (PW) and placental-to-birth weight (PWBW) ratio of acknowledged BW predictors.
  
  
  METHODS
  We performed a retrospective analysis of a prospective cohort database from a tertiary hospital. Inclusion criteria were singleton pregnancy, diagnosis of GDM, delivery between 1982 and 2011 and gestational age at birth ≥23 weeks. Multiple regression analysis was performed using as dependent variables BW, PW and PWBW ratio and as independent ones maternal characteristics at baseline, metabolic characteristics (GDM diagnosis, treatment, control), pregnancy-induced hypertension, gestational age at delivery and fetal sex. Two sensitivity analyses were performed.
  
  
  RESULTS
  We evaluated 2547 women, PW being available in 85.3%. BW was 3260g (2976, 3575), PW 620g (540, 720) and PWBW ratio 19.27 (17.20, 21.47). Among the 24 analyzed variables, there was an important overlap among those associated with BW, PW and PWBW ratio. For most characteristics associated with both BW and PW, the magnitude of the association was greater for the latter, both when promoting growth (i.e. prepregnancy body mass index, 3h plasma glucose at diagnosis) and when restricting it (insulin treatment).
  
  
  CONCLUSIONS
  We conclude that in women with GDM and singleton pregnancies, variables associated with BW, PW and PWBW ratio overlap. The latter is the result of disproportionate associations with BW and PW, usually larger with PW.
authors.affiliation: Endocrinology and Nutrition Department, Hospital de la Santa Creu i Sant Pau, Sant Antoni Mª Claret 167, 08025 Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Ramos
authors.affiliation: Endocrinology and Nutrition Department, Hospital de la Santa Creu i Sant Pau, Sant Antoni Mª Claret 167, 08025 Barcelona, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Caimari
authors.affiliation: Endocrinology and Nutrition Department, Hospital de la Santa Creu i Sant Pau, Sant Antoni Mª Claret 167, 08025 Barcelona, Spain.
authors.forename: I M
authors.initials: IM
authors.lastname: Pujol
authors.affiliation: Endocrinology and Nutrition Department, Hospital de la Santa Creu i Sant Pau, Sant Antoni Mª Claret 167, 08025 Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: García-Patterson
authors.affiliation: Pediatrics Department, Hospital de la Santa Creu i Sant Pau, Sant Antoni Mª Claret 167, 08025 Barcelona, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Ginovart
authors.affiliation: Gynecology and Obstetrics Department, Hospital de la Santa Creu i Sant Pau, Sant Antoni Mª Claret 167, 08025 Barcelona, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Adelantado
authors.affiliation: Endocrinology and Nutrition Department, Hospital de la Santa Creu i Sant Pau, Sant Antoni Mª Claret 167, 08025 Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Campus de la UAB, Plaza Cívica, s/n, 08193 Bellaterra, Spain; CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, Sinesio Delgado 4, 28029 Madrid, Spain. Electronic address: rcorcoy@santpau.cat.
authors.forename: R
authors.initials: R
authors.lastname: Corcoy
mesh_terms: D000328:Adult; D001724:Birth Weight / Q000502:physiology*; D015992:Body Mass Index; D016208:Databases, Factual; D016640:Diabetes, Gestational / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D047109:Fetal Development / Q000502:physiology*; D005865:Gestational Age; D006801:Humans; D009929:Organ Size / Q000502:physiology; D010920:Placenta / Q000473:pathology* / Q000503:physiopathology; D011247:Pregnancy; D012189:Retrospective Studies
keywords: Birth weight; Gestational diabetes mellitus; Placenta-to-birth weight ratio; Placental weight; Predictors