Sex-dependent influence of maternal predictors on fetal anthropometry in pregnancies with gestational diabetes mellitus
Abstract Background Third trimester fetal anthropometric parameters are known to predict neonatal complications. A better understanding of predictors of adverse fetal parameters might help to personalize the use and frequency of fetal ultrasound. The objectives of this study were: (a) to evaluate th...
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | https://doi.org/10.1186/s12884-022-04767-z |
| _version_ | 1818235049158377472 |
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| author | Maria-Christina Antoniou Leah Gilbert Justine Gross Jean-Benoît Rossel Céline Julie Fischer Fumeaux Yvan Vial Jardena Jacqueline Puder |
| author_facet | Maria-Christina Antoniou Leah Gilbert Justine Gross Jean-Benoît Rossel Céline Julie Fischer Fumeaux Yvan Vial Jardena Jacqueline Puder |
| author_sort | Maria-Christina Antoniou |
| collection | DOAJ |
| description | Abstract Background Third trimester fetal anthropometric parameters are known to predict neonatal complications. A better understanding of predictors of adverse fetal parameters might help to personalize the use and frequency of fetal ultrasound. The objectives of this study were: (a) to evaluate the utility of maternal sociodemographic, anthropometric and metabolic predictors to predict 3rd trimester fetal anthropometric parameters in women with gestational diabetes mellitus (GDM), (b) to assess whether the impact of these maternal predictors is fetal sex-dependent, and (c) to provide a risk stratification for markers of fetal overgrowth (fetal weight centile (FWC) and fetal abdominal circumference centile (FACC) depending on prepregnancy BMI and gestational weight gain (GWG) until the 1st GDM visit. Methods This prospective study included 189 women with GDM. Maternal predictors were age, ethnicity, prepregnancy BMI, GWG and excessive weight gain until the 1st GDM visit, fasting, 1-hour and 2-hour blood glucose oral glucose tolerance test values, HbA1c at the 1st visit and medical treatment requirement. Fetal outcomes included FWC, FWC >90% and <10%, FACC, FACC >90% and <10%, at 29 0/7 to 35 6/7 weeks of gestational age. We performed univariate and multivariate regression analyses and probability analyses. Results In multivariate analyses, prepregnancy BMI was associated with FWC, FWC > 90% and FACC. GWG until the 1st GDM visit was associated with FWC, FACC and FACC > 90% (all p ≤ 0.045). Other maternal parameters were not significantly associated with fetal anthropometry in multivariate analyses (all p ≥ 0.054). In female fetuses, only GWG was associated with FACC (p= 0.044). However, in male fetuses, prepregnancy BMI was associated with FWC, FWC > 90% and FACC and GWG with FWC in multivariate analyses (all p ≤ 0.030). In women with a prepregnancy BMI of ≥ 25 kg/m2 and a GWG until the 1st GDM visit ≥ 10.3 kg (mean GWG), the risk for FWC > 90% and FACC > 90% was 5.3 and 4 times higher than in their counterparts. Conclusions A personalized fetal ultrasound surveillance guided by fetal sex, prepregnancy BMI and GWG may be beneficial in reducing adverse fetal and neonatal outcomes. |
| first_indexed | 2024-12-12T11:47:47Z |
| format | Article |
| id | doaj.art-553b7608d97f461282b2a6fec22b409c |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-12T11:47:47Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-553b7608d97f461282b2a6fec22b409c2022-12-22T00:25:25ZengBMCBMC Pregnancy and Childbirth1471-23932022-06-0122111110.1186/s12884-022-04767-zSex-dependent influence of maternal predictors on fetal anthropometry in pregnancies with gestational diabetes mellitusMaria-Christina Antoniou0Leah Gilbert1Justine Gross2Jean-Benoît Rossel3Céline Julie Fischer Fumeaux4Yvan Vial5Jardena Jacqueline Puder6Pediatric Service, Department Woman Mother Child, University Hospital of LausanneObstetric Service, Department Woman Mother Child, University Hospital of LausanneObstetric Service, Department Woman Mother Child, University Hospital of LausanneCenter for Primary Care and Public Health (Unisanté), University of LausanneClinic of Neonatology, Department Woman Mother Child, University Hospital of LausanneObstetric Service, Department Woman Mother Child, University Hospital of LausanneObstetric Service, Department Woman Mother Child, University Hospital of LausanneAbstract Background Third trimester fetal anthropometric parameters are known to predict neonatal complications. A better understanding of predictors of adverse fetal parameters might help to personalize the use and frequency of fetal ultrasound. The objectives of this study were: (a) to evaluate the utility of maternal sociodemographic, anthropometric and metabolic predictors to predict 3rd trimester fetal anthropometric parameters in women with gestational diabetes mellitus (GDM), (b) to assess whether the impact of these maternal predictors is fetal sex-dependent, and (c) to provide a risk stratification for markers of fetal overgrowth (fetal weight centile (FWC) and fetal abdominal circumference centile (FACC) depending on prepregnancy BMI and gestational weight gain (GWG) until the 1st GDM visit. Methods This prospective study included 189 women with GDM. Maternal predictors were age, ethnicity, prepregnancy BMI, GWG and excessive weight gain until the 1st GDM visit, fasting, 1-hour and 2-hour blood glucose oral glucose tolerance test values, HbA1c at the 1st visit and medical treatment requirement. Fetal outcomes included FWC, FWC >90% and <10%, FACC, FACC >90% and <10%, at 29 0/7 to 35 6/7 weeks of gestational age. We performed univariate and multivariate regression analyses and probability analyses. Results In multivariate analyses, prepregnancy BMI was associated with FWC, FWC > 90% and FACC. GWG until the 1st GDM visit was associated with FWC, FACC and FACC > 90% (all p ≤ 0.045). Other maternal parameters were not significantly associated with fetal anthropometry in multivariate analyses (all p ≥ 0.054). In female fetuses, only GWG was associated with FACC (p= 0.044). However, in male fetuses, prepregnancy BMI was associated with FWC, FWC > 90% and FACC and GWG with FWC in multivariate analyses (all p ≤ 0.030). In women with a prepregnancy BMI of ≥ 25 kg/m2 and a GWG until the 1st GDM visit ≥ 10.3 kg (mean GWG), the risk for FWC > 90% and FACC > 90% was 5.3 and 4 times higher than in their counterparts. Conclusions A personalized fetal ultrasound surveillance guided by fetal sex, prepregnancy BMI and GWG may be beneficial in reducing adverse fetal and neonatal outcomes.https://doi.org/10.1186/s12884-022-04767-zGestational diabetesFetal ultrasoundFetal anthropometryFetal sexRisk stratification |
| spellingShingle | Maria-Christina Antoniou Leah Gilbert Justine Gross Jean-Benoît Rossel Céline Julie Fischer Fumeaux Yvan Vial Jardena Jacqueline Puder Sex-dependent influence of maternal predictors on fetal anthropometry in pregnancies with gestational diabetes mellitus BMC Pregnancy and Childbirth Gestational diabetes Fetal ultrasound Fetal anthropometry Fetal sex Risk stratification |
| title | Sex-dependent influence of maternal predictors on fetal anthropometry in pregnancies with gestational diabetes mellitus |
| title_full | Sex-dependent influence of maternal predictors on fetal anthropometry in pregnancies with gestational diabetes mellitus |
| title_fullStr | Sex-dependent influence of maternal predictors on fetal anthropometry in pregnancies with gestational diabetes mellitus |
| title_full_unstemmed | Sex-dependent influence of maternal predictors on fetal anthropometry in pregnancies with gestational diabetes mellitus |
| title_short | Sex-dependent influence of maternal predictors on fetal anthropometry in pregnancies with gestational diabetes mellitus |
| title_sort | sex dependent influence of maternal predictors on fetal anthropometry in pregnancies with gestational diabetes mellitus |
| topic | Gestational diabetes Fetal ultrasound Fetal anthropometry Fetal sex Risk stratification |
| url | https://doi.org/10.1186/s12884-022-04767-z |
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