open access

Vol 92, No 2 (2021)
Research paper
Published online: 2021-02-26
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Fetal growth trajectory in type 1 pregestational diabetes (PGDM) — an ultrasound study

Lukasz Adamczak1, Daniel Boron1, Pawel Gutaj1, Grzegorz H. Breborowicz2, Jerzy Moczko3, Ewa Wender-Ozegowska1
DOI: 10.5603/GP.a2020.0136
·
Ginekol Pol 2021;92(2):110-117.
Affiliations
  1. Department of Reproduction, Chair of Obstertics, Gynecology and Gynecological Oncology, Poznan University of Medical Sciences, Poland, Poland
  2. Department of Gynecological Oncology, Chair of Obstertics, Gynecology and Gynecological Oncology, Poznan, Poland, Poland
  3. Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poland, Poland

open access

Vol 92, No 2 (2021)
ORIGINAL PAPERS Obstetrics
Published online: 2021-02-26

Abstract

Objectives: Growth disorders are frequent in diabetic pregnancies. However, they are difficult to predict and capture early
during pregnancy. These newborns are at risk of obesity, diabetes, and cardiovascular disease. While developing, fetal
growth abnormalities are typically progressive. Therefore, capturing the earliest moment when they emerge is essential
to guide subsequent obstetric management.
Material and methods: We aimed to analyze fetal ultrasound growth trajectories in type 1 diabetics. Moreover, we aimed
to establish time points when first ultrasound manifestations of fetal growth abnormalities appear and to identify factors
that affect fetal growth in women with diabetes.
We collected clinical and ultrasound data from 200 patients with PGDM managed in the third-referential centre for diabetes
in pregnancy. During every visit, patients underwent an ultrasound examination according to a standard protocol giving
1072 ultrasound scan’s records. Every ultrasound consisted of fetal weight estimation, according to the Hadlock 3 formula.
Retrospectively patients were divided into three groups depending on neonatal weight. In the group of 200 patients,
60 (30%) delivered LGA and 9 (4.5%) SGA newborns.
Results: Fetal growth trajectories show different patterns among fetuses with growth abnormalities in women with
type 1 diabetes. The moment, when fetal growth curves diverge, seems to take place in the second trimester, just after
the 23rd week of gestation.
Conclusions: It suggests that fetal growth abnormalities in type 1 diabetes may have its roots much earlier than expected.
In the first trimester, there were differences in LDL-cholesterol, total cholesterol, triglyceride levels and in insulin requirements
between AGA, SGA and LGA subgroups.

Abstract

Objectives: Growth disorders are frequent in diabetic pregnancies. However, they are difficult to predict and capture early
during pregnancy. These newborns are at risk of obesity, diabetes, and cardiovascular disease. While developing, fetal
growth abnormalities are typically progressive. Therefore, capturing the earliest moment when they emerge is essential
to guide subsequent obstetric management.
Material and methods: We aimed to analyze fetal ultrasound growth trajectories in type 1 diabetics. Moreover, we aimed
to establish time points when first ultrasound manifestations of fetal growth abnormalities appear and to identify factors
that affect fetal growth in women with diabetes.
We collected clinical and ultrasound data from 200 patients with PGDM managed in the third-referential centre for diabetes
in pregnancy. During every visit, patients underwent an ultrasound examination according to a standard protocol giving
1072 ultrasound scan’s records. Every ultrasound consisted of fetal weight estimation, according to the Hadlock 3 formula.
Retrospectively patients were divided into three groups depending on neonatal weight. In the group of 200 patients,
60 (30%) delivered LGA and 9 (4.5%) SGA newborns.
Results: Fetal growth trajectories show different patterns among fetuses with growth abnormalities in women with
type 1 diabetes. The moment, when fetal growth curves diverge, seems to take place in the second trimester, just after
the 23rd week of gestation.
Conclusions: It suggests that fetal growth abnormalities in type 1 diabetes may have its roots much earlier than expected.
In the first trimester, there were differences in LDL-cholesterol, total cholesterol, triglyceride levels and in insulin requirements
between AGA, SGA and LGA subgroups.

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Keywords

fetal growth; pregestational diabetes; ultrasound; type 1 diabetes mellitus

About this article
Title

Fetal growth trajectory in type 1 pregestational diabetes (PGDM) — an ultrasound study

Journal

Ginekologia Polska

Issue

Vol 92, No 2 (2021)

Article type

Research paper

Pages

110-117

Published online

2021-02-26

DOI

10.5603/GP.a2020.0136

Bibliographic record

Ginekol Pol 2021;92(2):110-117.

Keywords

fetal growth
pregestational diabetes
ultrasound
type 1 diabetes mellitus

Authors

Lukasz Adamczak
Daniel Boron
Pawel Gutaj
Grzegorz H. Breborowicz
Jerzy Moczko
Ewa Wender-Ozegowska

References (18)
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