P20.02: Prediction of adverse perinatal outcomes using fetal biometric parameters in women with gestational diabetes mellitus: a Korean multicentre study

Abstract

The purpose of this study was to evaluate the predictive performance of fetal biometric parameters measured around the time of gestational diabetes mellitus (GDM) screening and within 2 weeks before delivery in predicting adverse perinatal outcomes in women with GDM. This was a retrospective cohort study of 603 women with singleton pregnancies with GDM in 4 tertiary care hospitals from 2006 to 2013. We obtained clinical information and fetal biometric parameters such as biparietal diameter (BPD dia), abdominal circumference (AC dia), abdominal diameter (AD dia, AC/π), femur length (FL dia), and estimated fetal weight (EFW dia) measured around the time of GDM diagnosis (dia) and done before delivery (del) and interval changes of these values from medical records. Using these, predictive performance was assessed in predicting perinatal outcomes such as large for gestational age (LGA), macrosomia, shoulder dystocia, NICU admission, respiratory distress syndrome (RDS), neonatal hypoglycemia, low apgar score, Caesarean delivery due to cephalopelvic disproportion (CPD) and postpartum overt diabetes. AC del, AD del, EFW del, (AD minus BPD) del, and (AC minus HC) del were statistically different between groups with and without LGA, macrosomia, NICU admission, RDS, Caesarean delivery due to CPD (P < 0.05). Changes in EFW per week (EFW / weeks) also showed a statistically significant result in LGA and macrosomia. EFW/weeks (area under the curve (AUC) = 0.804 in LGA, 0.836 in macrosomia) was associated with an increased risk of LGA and macrosomia and AC or AD del and EFW del also did. No parameters were significant in predicting neonatal hypoglycemia, low apgar score and postpartum overt diabetes. Fetal biometric parameters and those interval changes may be useful for predicting some adverse perinatal outcomes in women with GDM.