Maternal and fetal glucose metabolism in fetal macrosomia of diabetic and non-diabetic pregnancies

Abstract EN

Macrosomia (birth weight < 4000g) is associated with a variety of maternal risk factors.

Abnormality of carbohydrate metabolism during pregnancy, which may not be detectable by glucose tolerance test (GTT) has been suggested as one of the main factors. Method: We measured blood glucose, glycated hemoglobin (HbA1C), insulin, fructosamine and peptide immediately after delivery in 3 groups of mothers.

(1) 23 known diabetic and gestational diabetic mothers.

(2) 49 non-diabetic mothers.

These two groups delivered full-term macrosomic infants (3) 46 non-diabetic mothers who delivered full-term appropriate for gestational age infants as control. Result: Mothers of macrosomic infants, compared to mothers of appropriate for gestational age infants, were significantly older, with a higher gravidity and parity.

When all the mean values were adjusted for maternal age, parity and gravidity, the HbA1C, fructosamine and glucose were lowest in mothers of appropriate for gestational age infants and highest in diabetic mothers of macrosomic infants.

Hypoglyceaemia was more common in both groups of macrosomic infants and the cord blood fructosamice and insulin were not different. Conclusion: Although the trend of material blood samples in our study was suggestive of some abnormal carbohydrate metabolism in mothers who delivered macrosomic infants compared of appropriate for gestational age infants, these findings have not been confirmed in their babies.

The possible role of abnormal glucose metabolism as a risk factor for fetal macrosomia in non-diabetic mothers should be further studied.