Asymmetric Large-for-Gestational-Age Infants of Type 1 Diabetic Women: Morbidity and Abdominal Growth

作者：Bollepalli Sureka^*; Dolan Lawrence M; Miodovnik Menachem; Feghali Maisa; Khoury Jane C

来源：American Journal of Perinatology, 2010, 27(8): 603-609.

DOI：10.1055/s-0030-1249362

• Large for gestational age
• type 1 diabetes
• abdominal circumference
• ultrasound

We sought to examine neonatal morbidity in four groups of offspring (asymmetric large for gestational age [LGA], symmetric LGA, asymmetric non-LGA, symmetric non-LGA) exposed in utero to maternal type 1 diabetes, and the association between rate of fetal abdominal circumference growth and asymmetric LGA. We performed a secondary analysis of 302 singleton pregnancies. Neonatal morbidity (respiratory distress syndrome, polycythemia, hypoglycemia, hyperbilirubinemia, acidosis, and composite morbidity [any of the five]) was assessed. Serial ultrasound examinations after 20 weeks' gestation were available for 35 fetuses. Logistic regression and general linear mixed modeling were used for analysis. Asymmetric LGA infants had 3.5-, 2.2-, and 3.2-fold greater odds of hypoglycemia, hyperbilirubinemia, and composite morbidity, respectively, compared with symmetric non-LGA infants. The rate of growth of the abdominal circumference in asymmetric LGA infants (1.11 cm/wk) was greater than for both the symmetric LGA infants (0.87 cm/wk, p = 0.09) and the symmetric non-LGA infants (0.87 cm/wk, p = 0.03). Asymmetric LGA infants are at higher risk for morbidity than symmetric LGA and non-LGA infants. Intrauterine growth rate of the abdominal circumference may potentially be used as a marker to identify the asymmetric LGA and thereby aid in the identification of newborns at greatest risk for perinatal complications.

• 出版日期2010-9