Risk Factors For Fetal Macrosomia Research Articles

Cord leptin level and fetal macrosomia

Objective: To determine the relationships among serum leptin, insulin-like growth factor-I, and insulin levels in large for gestational age (LGA) infants. Methods: Serum samples were collected from maternal veins and umbilical arteries of 52 consecutive, term, LGA neonates of nondiabetic mothers. Maternal and neonatal serum samples were analyzed for levels of leptin, insulin-like growth factor-I, and insulin by specific radioimmunoassays. Multiple regression analysis was used to determine independent risk factors for fetal macrosomia. Results: The independent risk factor significantly associated with fetal macrosomia was umbilical cord leptin concentration ( P < .01, β = 0.59). There was a statistically significant correlation between umbilical cord leptin and insulin-like growth factor-I levels and birth weight ( r = 0.51, P < .01; r = 0.37, P < .01; respectively). The correlation between umbilical cord insulin levels and birth weight was not statistically significant ( r = 0.06, P = .63), nor was that between maternal body mass index and birth weight ( r = 0.09, P = .50). Conclusion: Our data showed that umbilical cord leptin concentration was an independent risk factor for fetal macrosomia.

Cord Leptin Level and Fetal Macrosomia

In Brief Objective To determine the relationships among serum leptin, insulin-like growth factor-I, and insulin levels in large for gestational age (LGA) infants. Methods Serum samples were collected from maternal veins and umbilical arteries of 52 consecutive, term, LGA neonates of nondiabetic mothers. Maternal and neonatal serum samples were analyzed for levels of leptin, insulin-like growth factor-I, and insulin by specific radioimmunoassays. Multiple regression analysis was used to determine independent risk factors for fetal macrosomia. Results The independent risk factor significantly associated with fetal macrosomia was umbilical cord leptin concentration (P < .01, β = 0.59). There was a statistically significant correlation between umbilical cord leptin and insulin-like growth factor-I levels and birth weight (r = 0.51, P < .01; r = 0.37, P < .01; respectively). The correlation between umbilical cord insulin levels and birth weight was not statistically significant (r = 0.06, P = .63), nor was that between maternal body mass index and birth weight (r = 0.09, P = .50). Conclusion Our data showed that umbilical cord leptin concentration was an independent risk factor for fetal macrosomia. Umbilical cord leptin concentration is an independent factor associated with macrosomia.

Risk factors for fetal macrosomia: the importance of a positive oral glucose challenge test.

The aim of this study was to investigate whether minor abnormalities of glucose metabolism without gestational diabetes are a risk factor for fetal overgrowth. A sample of 1883 unselected white mother-infant pairs were screened for gestational diabetes using a 50 g 1-h oral glucose challenge test (GCT) in two periods of pregnancy: early (16-20 weeks) and late (26-30 weeks). The effects of risk factors (glucose metabolism, previous history of mothers, obesity, multiparity and age of mothers) were estimated using a multinomial logit model. The level of risk was related to gestational age at the appearance of an abnormal GCT. Patients with an abnormal GCT in the early and late periods of pregnancy (Group 1) had a risk of delivering a large for gestational age (LGA) infant seven times higher than the control group (normal GCT in both periods), and patients with a normal GCT in the early period and an abnormal GCT in the late period (Group 2) showed a risk three times higher than the control group. Among the historical risk factors for LGA infants, such as maternal obesity, multiparity, previous gestational diabetes and previous delivery of an infant weighing 4000 g or more, only the latter was associated with fetal overgrowth with a risk level 4.7 higher than the control group. Group 1 patients had a significantly higher incidence of pregnancy-induced hypertension and preterm birth. There were no differences in the frequency of 5-min Apgar score < 7 and metabolic complications among the infants of all groups. We found a significantly higher rate of shoulder dystocia in Group 1 infants than in infants in the other groups. Our results suggest that a positive GCT at 26-30 weeks is the most important risk factor for fetal overgrowth. This result was strongly enforced in patients who had also shown a positive early GCT at 16-20 weeks.

Ultrasonographic detection of abnormal fetal growth with the gestational age-independent, transverse cerebellar diameter/abdominal circumference ratio

We prospectively evaluated the accuracy of a gestational age-independent method of detecting abnormal growth, the transverse cerebellar diameter/abdominal circumference ratio, and compared this with standard ultrasonographic methods of growth assessment. We prospectively studied 825 low-risk obstetric patients and 250 patients having risk factors for fetal macrosomia (n = 92) or growth retardation (n = 158). Measured fetal parameters included the biparietal diameter, head circumference, transverse cerebellar diameter, abdominal circumference, and femur length. The estimated fetal weight, head circumference/abdominal circumference, cerebellar diameter/abdominal circumference, and femur length/abdominal circumference ratios were calculated. Reference curves for these parameters were created from a cross-sectional analysis of the low-risk group. Univariate analysis was used to determine the sensitivity, specificity, predictive values, and odds ratios of each individual parameter in identifying a small- or large-for-gestational-age infant. A multivariate logistic regression model with a variable selection procedure was then used to determine whether significance remained when we controlled for other parameters. Within the low-risk group, the transverse cerebellar/abdominal circumference ratio was gestational age independent between 14 and 42 weeks with a mean of 13.68 +/- 0.96. A value exceeding 2 SD of the mean was significantly associated with birth or a small-for-gestational-age infant, being abnormal in 98% and 71% of asymmetrically and symmetrically growth-retarded infants, respectively. Significance was maintained in the multivariate regression model. The ratio was not helpful in detecting the large-for-gestational-age infant. The fetal transverse cerebellar diameter/abdominal circumference ratio is an accurate, gestational age-independent method of identifying the small-for-gestational-age but not the large-for-gestational-age infant.

Abnormal glucose screening tests in pregnancy: A risk factor for fetal macrosomia

International Journal of Gynecology & ObstetricsVolume 26, Issue 1 p. 168-168 Citations from the literature diseases in pregnancy Abnormal glucose screening tests in pregnancy: A risk factor for fetal macrosomia EL Leikin, EL LeikinSearch for more papers by this authorJH Jenkins, JH JenkinsSearch for more papers by this authorGA Pomerantz, GA PomerantzSearch for more papers by this authorL Klein, L KleinSearch for more papers by this author EL Leikin, EL LeikinSearch for more papers by this authorJH Jenkins, JH JenkinsSearch for more papers by this authorGA Pomerantz, GA PomerantzSearch for more papers by this authorL Klein, L KleinSearch for more papers by this author First published: February 1988 https://doi.org/10.1016/0020-7292(88)90247-0AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume26, Issue1February 1988Pages 168-168 RelatedInformation