Fetal parameters and early evidence of fetal macrosomia in prepregnancy diabetic women

Abstract

Background: Diabetes in pregnancy with macrosomia is an important risk factor for neonatal morbidity and mortality. Prediction of macrosomia is significantly improved by adding ultrasound to clinical findings. Objective: For earlier detection of macrosomia in prepregnancy diabetic mothers using fetal growth profile including biparietal diameter, femoral length, and also abdominal circumference (AC). Patients and Methods: A historical prospective cohort study was performed at National Endocrine and Diabetic Center in addition to the Obstetrics and Gynecology Department at Al-Yarmouk Hospital for 2 years, from September 2014 to 2016. A hundred and sixty pregnant women were enrolled in this study, 80 of them with a history of prepregnancy diabetes mellitus were taken as a patient group and the other 80 pregnant women with a compatible gestational age and without a history of diabetes mellitus were taken as a comparison group. Abdominal ultrasound was done for patients in both groups at 20, 28, and 36 weeks of gestation and then birth weight was measured for each. Results were compared between two groups. Results: The incident of macrosomia was 30% in patient group and 10% in comparison group. Regarding early prediction of macrosomia by ultrasound using biparietal diameter, femoral length, and AC, the results of the current study revealed that those macrosomic babies have higher femoral length, AC but not biparietal diameter in comparison with babies of average weight using ultrasound performed at 20-week gestation and repeated at 28 and 36 weeks. Conclusion: In diabetic mother, fetal macrosomia can be predicted by ultrasound during pregnancy as early as 20-week gestation.