title: Fetal growth trajectories in pregnancies of European and South Asian mothers with and without gestational diabetes, a population-based cohort study.
abstract: OBJECTIVE
  Our aim was to examine the impact of gestational diabetes (GDM), from before the GDM-diagnosis is made, on fetal growth trajectories, and to compare it in Europeans and South Asians; two ethnic groups with dissimilar fetal growth patterns.
  
  
  METHODS
  We studied European (n = 349) and South Asian (n = 184) pregnant women, from the population-based STORK-Groruddalen cohort in Oslo, Norway. Mothers were enrolled in early pregnancy, screened for GDM in gestational week 28 ±2, and classified as "non-GDM", "mild GDM" or "moderate/severe GDM". We measured fetal head circumference, abdominal circumference and femur length by ultrasound, and estimated fetal weight in gestational week 24, 32 and 37, and performed corresponding measurements at birth.
  
  
  RESULTS
  In non-GDM pregnancies, South Asian fetuses (n = 156) had a slower growth from gestational week 24, compared with Europeans (n = 310). More than two thirds of the European mothers later diagnosed with GDM were overweight or obese in early pregnancy, while this was not observed in South Asians. Fetuses of GDM mothers tended to be smaller than fetuses of non-GDM mothers in week 24, but thereafter grew faster until birth. This pattern was especially pronounced in fetuses of South Asian mothers with moderate/severe GDM. In week 24 these fetuses had a -0.95 SD (95% CI: -1.53, -0.36) lower estimated fetal weight than their non-GDM counterparts. In contrast, at birth they were 0.45 SD (0.09, 0.81) larger.
  
  
  CONCLUSIONS
  Offspring of GDM mothers were smaller in mid pregnancy, but subsequently grew faster until birth, compared with offspring of non-GDM mothers. This pattern was most prominent in South Asian mothers with moderate to severe GDM. However, the most remarkable characteristic of these fetuses was not a large size at birth, but the small size in mid pregnancy, before the GDM diagnosis was set.
authors.affiliation: Dept. of Pediatric and Adolescents Medicine, Akershus University Hospital, Lørenskog, Norway.
authors.forename: Line
authors.identifier: http://orcid.org/0000-0002-5085-7366
authors.initials: L
authors.lastname: Sletner
authors.affiliation: Dept. of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway.
authors.forename: Anne Karen
authors.initials: AK
authors.lastname: Jenum
authors.affiliation: Diabetes Unit, King Edward Memorial Hospital Research Centre, Pune, India.
authors.forename: Chittaranjan S
authors.initials: CS
authors.lastname: Yajnik
authors.affiliation: Dept. of International Public Health, Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: Kjersti
authors.initials: K
authors.lastname: Mørkrid
authors.affiliation: Dept. of Pediatric and Adolescents Medicine, Akershus University Hospital, Lørenskog, Norway.|Institute of Clinical Medicine, Campus Ahus, University of Oslo, Lørenskog, Norway.
authors.forename: Britt
authors.initials: B
authors.lastname: Nakstad
authors.affiliation: Faculty of Health, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
authors.forename: Odd Harald
authors.initials: OH
authors.lastname: Rognerud-Jensen
authors.affiliation: Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.|Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors.forename: Kåre I
authors.initials: KI
authors.lastname: Birkeland
authors.affiliation: Norwegian National Advisory Unit on Women`s Health, Department for Woman and Child Health, Oslo University Hospital, Oslo, Norway.
authors.forename: Siri
authors.initials: S
authors.lastname: Vangen
mesh_terms: D000328:Adult; D000886:Anthropometry; D001208:Asia; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000503:physiopathology*; D005060:Europe; D005260:Female; D047109:Fetal Development; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy