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Maternal glycoregulation in pregnancies complicated by diabetes mellitus in the prediction of fetal echography findings and perinatal outcomes
Author(s) -
Babović Ivana,
Arandjelović Milica,
Plešinac Snežana,
KontićVučinić Olivera,
Radunović Nebojša
Publication year - 2018
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13537
Subject(s) - medicine , body mass index , gestational diabetes , obstetrics , respiratory distress , fetus , mass index , gestational age , placental insufficiency , diabetes mellitus , glycemic , pregnancy , interventricular septum , diastole , insulin , gestation , endocrinology , placenta , surgery , blood pressure , ventricle , biology , genetics
Abstract Aim We aimed to determine maternal hemoglobin A1c (HbA1c) levels and pregestational body mass index (BMI) as the predictors of glycemic control and its importance for fetal echography findings and perinatal outcomes in pregnancies complicated by diabetes mellitus (DM). Methods Our intention was to evaluate how BMI and HbA1c levels might be used to predict fetal interventricular septum (IVS) thickness, atrioventricular inflow early diastole (E)/ atrial systole (A) velocity ratio, and perinatal outcomes. Patients in the 38th gestational week were divided into three groups according to their insulin therapy: (i) patients with gestational diabetes mellitus (GDM) treated only with dietary changes (GDM group, n = 32); (ii) patients with GDM treated with insulin therapy (DM2 group, n = 27); and (iii) patients with type 1 DM (DM1 group, n = 22). Results In the DM1 group, we found statistically significant correlations between BMI and IVS thickness ( P = 0.036), HbA1c and IVS thickness, as well as the mitral E/A velocity ratio ( P = 0.013 vs P = 0.007). In this group, HbA1c showed a statistically significant correlation to neonatal birth weight ( P = 0.037) and BMI influenced on appearance respiratory distress syndrome in neonates in DM1 group ( P = 0.027). The values of HbA1c predict neonatal respiratory distress syndrome in DM2 and GDM groups ( P = 0.036). Conclusion As good predictors of maternal glycoregulation, BMI and HbA1c levels determine fetal echography findings as well as neonatal outcomes in pregnancies complicated by DM.