Prediction of Insulin Therapy Initiation in Women with Gestational Diabetes Mellitus based on Fetal Abdominal Circumference at the Time of Diagnosis - DOH-Net
The Diabetes, Obesity and Hypertension in Pregnancy Research Network (DOH-Net) is a multi-disciplinary research team of obstetrical, midwifery and maternal-fetal medicine specialists.
DOH-Net, research, diabetes, hypertension, obesity, pregnancy, gestational diabetes, diabetes, obesity and hypertension in pregnancy research network, Sunnybrook Health Sciences Centre, St. Michael's Hospital, McMaster University, obstetrics, midwife, maternal-fetal medicine, specialists, researchers, Toronto, Ontario, Canada, Hamilton, Greater Toronto Area, GTA
620
post-template-default,single,single-post,postid-620,single-format-standard,ajax_fade,page_not_loaded,,qode_grid_1300,footer_responsive_adv,qode-content-sidebar-responsive,qode-theme-ver-13.6,qode-theme-bridge,wpb-js-composer js-comp-ver-5.4.5,vc_responsive
 

Prediction of Insulin Therapy Initiation in Women with Gestational Diabetes Mellitus based on Fetal Abdominal Circumference at the Time of Diagnosis

Failure of lifestyle and nutritional modification in Gestational Diabetes Mellitus (GDM) has been the target of numerous studies all aiming to better stratify GDM patients into risk groups. Clinical characteristics such as pre-pregnancy BMI, Fasting glucose level and family history of diabetes, have all been found to be associated with the need for insulin treatment.  A fasting GTT glucose level of > 105 had a sensitivity of 30.86% and a specificity of 91.89% in predicting the need for Insulin treatment. Fetal organomegaly, and specifically hepatomegaly leading to a measurable increase in abdominal circumference is a known measure of fetal exposure to maternal hyperglycemia. Thus the use of the fetal abdominal circumference measurement at the time of GDM diagnosis is theoretically a biologically plausible marker of both the need for medical management of GDM as well as increased risk of adverse perinatal outcomes but there is currently limited evidence to support this.

The aim of this retrospective chart review study was to assess the potential role of the fetal AC measurement (alone and in combination with clinical risk factors) at the time of GDM diagnosis, as a predictor of failure of lifestyle and nutritional modification in GDM pregnancies. Our hypothesis is that the AC percentile at that time will predict the need for medical management of GDM, thus enabling early stratification of pregnant women with GDM into low and high risk groups.

Contact for this study:
Karizma Mawjee, mawjeek@smh.ca