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We studied the relationship between maternal glycemia at 28 weeks gestation and fetal adiposity measured using ultrasound in the third trimester.
After Gestational Diabetes Mellitus(GDM) was excluded by a diagnostic Oral Glucose Tolerance Test (OGTT) at 28 weeks gestation, healthy women with a singleton pregnancy were recruited at their convenience. Consent was obtained. Sonographic fetal soft tissue measurements were used to assess adiposity at 28 and 37 weeks. Gestational weight gain (GWG) was measured. Statistical analysis included multiple regression.
In the 231 women studied the mean age was 30.6 years. 41.1% (n=95) were primigravidas. The mean early pregnancy BMI was 28.2 kg/m2. Maternal glucose levels correlated with the fetal abdominal subcutaneous tissue measurements (r=0.2; p=0.014) and abdominal circumference (AC), (r=0.1; p=0.04). Maternal glucose levels did not correlate with the fetal mid-thigh muscle thickness and mid-thigh subcutaneous tissue measurements. Fasting and 1 hour post prandial OGTT levels were significantly associated with AC and abdominal subcutaneous tissue measurements. Glucose levels at 2 and 3 hours post prandial correlated with increased abdominal subcutaneous tissue but not with fetal AC (Table). There was no significant association between gestational weight gain (GWG) and fetal adiposity.
Recent studied have shown that higher maternal glucose levels short of GDM were associated with large for gestational age babies and neonatal adiposity. Our study shows that in women who do not have GDM, higher maternal glucose levels at 28 weeks gestation appear to influence the distribution of fetal fat as well as the amount of fat. The lifelong impact of intrauterine programming by maternal glycemia on the distribution of fetal fat remains uncertain.