Using 75 g OGTT in Prediction for Macrosomia in Gestational Diabetes Mellitus

Abstract

Gestational Diabetes mellitus (GDM) is defined as carbohydrate intolerance with diوٴerent degrees of severity which occurs or is recognized for the first time during pregnancy. Fetal birth weight above the 90th percentile for gestational week and newborns weight equal or higher than 4000 g is defined as macrosomia [1]. About 15-45% of babies born from mothers with GDM can have macrosomia, which is 3-fold higher in comparison to normoglycemic controls (12%). Macrosomic infants from mothers with GDM are related to risk of developing overweight, obesity in adulthood, and type 2 diabetes mellitus and cardiovascular diseases later in life. Several studies showed that epigenetic alterations of diوٴerent genes of the fetuses of a GDM mother in utero could result in transgenerational transmission of GDM and type 2 diabetes mellitus [1]. Нus, hyperglycemia begets hyperglycemia. Нere is no doubt that maternal hyperglycemia plays a very important role in fetal overgrowth [1,2]. Нe first hour aіer beginning of the meal is associated as best predictor of subsequent macrosomia [2]. Unlike maternal hyperglycemia, obesity is the strongest and independent predictor for fetal macrosomia [3,4]. Maternal prepregnancy body mass index (BMI) [1], pregnancy weight gain [2], maternal height, maternal age at delivery, hypertension and cigarette smoking have a significant impact. Нe predictive ability of the glucose levels from the 2-h 75-g OGTT in terms of pregnancy outcomes has been investigated little until the HAPO study [5]. Нus, the objective of the mini report is to evaluate the association between glucose levels of 75-g OGTT and perinatal outcomes, in 118 pregnant women who were prospectively screened for GDM between 24 and 28 weeks of pregnancy [6].