title: Placental Weight in Pregnant Women with Type 1 Diabetes Mellitus: The Association with Fetal Growth.
abstract: ObjectiveTo determine the association between placental weight (PW) and large for gestational age (LGA) in women with type 1 diabetes mellitus (T1DM) and whether glycemic control modifies the association.Study DesignIn a retrospective analysis of a cohort of women with T1DM, poor glycemic control was defined as glycohemoglobin A1(HbA1)≥ 8.5% (≥2 standard deviations [SD] above mean), and LGA as birth weight > 90th percentile, according to gestation, race, and sex. Multivariable logistic regression was used for analysis. Stratified analyses (HbA1< 8.5% vs. HbA1≥ 8.5%) assessed the role of glycemic control on association between PW and LGA.ResultsPW in 302 pregnancies was positively associated with LGA (first vs. fourth quartile of PW; odds ratio [OR] = 9.56; 95% confidence interval [CI]: 4.14-22.08). Association varied significantly by glycemic control in the first trimester, but not in the second and third trimesters. For women with first trimester HbA1concentration < 8.5%, there was no statistically significant association; however, with HbA1≥ 8.5%, there was a strong association (OR = 13.40, 95% CI: 3.31, 54.27).ConclusionThere was a significant positive association between PW and LGA in infants of women with T1DM, particularly evident in pregnancies with poor glycemic control during the first trimester, highlighting the importance of achieving good glycemic control early in gestation.
authors.affiliation: Department of Biological Sciences, Loyola University, Chicago, Illinois.
authors.forename: Supal
authors.initials: S
authors.lastname: Mehta
authors.affiliation: Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Jane
authors.initials: J
authors.lastname: Khoury
authors.affiliation: Pregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
authors.forename: Menachem
authors.initials: M
authors.lastname: Miodovnik
authors.affiliation: MedStar Washington Hospital Center, Washington, District of Columbia.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kawakita
authors.affiliation: Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Shelley
authors.initials: S
authors.lastname: Ehrlich
authors.affiliation: Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Katherine
authors.initials: K
authors.lastname: Bowers
mesh_terms: D000328:Adult; D001724:Birth Weight; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications; D005260:Female; D047109:Fetal Development; D005320:Fetal Macrosomia / Q000097:blood* / Q000209:etiology; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008137:Longitudinal Studies; D009929:Organ Size; D010920:Placenta / Q000473:pathology*; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood; D011254:Pregnancy in Diabetics / Q000097:blood*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin