Diabetes & Metabolism Journal

Original Article

Metabolic Risk/Epidemiology
Fetal Abdominal Obesity Detected At 24 to 28 Weeks of Gestation Persists Until Delivery Despite Management of Gestational Diabetes Mellitus: Wonjin Kim, Soo Kyung Park, Yoo Lee Kim; Diabetes Metab J. 2021;45(4):547-557. Published online March 5, 2021; DOI: https://doi.org/10.4093/dmj.2020.0078

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Background
Fetal abdominal obesity (FAO) has been reported to be affected at gestational diabetes mellitus (GDM) diagnosis at 24 to 28 weeks of gestation in older and/or obese women. This study investigated whether the management of GDM improves FAO in GDM subjects near term.
Methods
Medical records of 7,099 singleton pregnant women delivering at CHA Gangnam Medical Center were reviewed retrospectively. GDM was diagnosed by 100-g oral glucose tolerance test after 50-g glucose challenge test based on Carpenter–Coustan criteria. GDM subjects were divided into four study groups according to maternal age and obesity. FAO was defined as ≥90th percentile of fetal abdominal overgrowth ratios (FAORs) of the ultrasonographically estimated gestational age (GA) of abdominal circumference per actual GA by the last menstruation period, biparietal diameter, or femur length, respectively.
Results
As compared with normal glucose tolerance (NGT) subjects near term, FAORs and odds ratio for FAO were significantly higher in old and/or obese women with GDM but not in young and nonobese women with GDM. For fetuses of GDM subjects with FAO at the time of GDM diagnosis, the odds ratio for exhibiting FAO near term and being large for GA at birth were 7.87 (95% confidence interval [CI], 4.38 to 14.15) and 10.96 (95% CI, 5.58 to 20.53) compared with fetuses of NGT subjects without FAO at GDM diagnosis.
Conclusion
Despite treatment, FAO detected at the time of GDM diagnosis persisted until delivery. Early diagnosis and treatment might be necessary to prevent near term FAO in high-risk older and/or obese women.

Citations

Citations to this article as recorded by

The effects of gestational diabetes mellitus on fetal growth: is it different for low-risk and medium–high-risk pregnant women?
Jie Wang, Xin Cheng, Zhen-Hua Li, Yi-Cheng Mao, Xin-Qiang Wang, Kang-Di Zhang, Wen-Jie Yu, Ying-Qing Li, Jia-wen Zhao, Mao-Lin Chen, Guo-peng Gao, Cheng-Yang Hu, Xiu-Jun Zhang
Archives of Gynecology and Obstetrics.2023;[Epub] CrossRef
Fetal abdominal obesity and the ensuing adverse perinatal outcomes in older obese pregnant women with or without obesity and with normal glucose tolerance
Wonjin Kim, Soo Kyung Park, Yoo Lee Kim
Scientific Reports.2023;[Epub] CrossRef
Early-life exposure to gestational diabetes mellitus predisposes offspring to pediatric nonalcoholic fatty liver disease
Qian-Ren Zhang, Yan Dong, Jian-Gao Fan
Hepatobiliary & Pancreatic Diseases International.2023;[Epub] CrossRef
Gestational diabetes mellitus and adverse pregnancy outcomes: systematic review and meta-analysis
Wenrui Ye, Cong Luo, Jing Huang, Chenglong Li, Zhixiong Liu, Fangkun Liu
BMJ.2022; : e067946. CrossRef
Fetal abdominal overgrowth is already present at 20–24 gestational weeks prior to diagnosis of gestational diabetes mellitus
Wonjin Kim, Soo Kyung Park, Yoo Lee Kim
Scientific Reports.2021;[Epub] CrossRef

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