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To determine if measuring fetal subcutaneous fat and liver antenatally using ultrasound can predict macrosomia in pregnancies with pre-gestational diabetes.
We performed a prospective study in a level III university center. 29 pregnant women with pre-gestational diabetes were included. Fetal biometry, subcutaneous fat tissue thickness (anterior abdominal wall, thigh, upper arm and scapula) and liver size were sonographically evaluated at 23, 28, 31 and 34 weeks of gestation. Large for gestational age (LGA) was defined as birthweight >90th percentile of customized standards adjusted for maternal height and weight, parity, fetal gender, and gestational age. Areas (+/− standard error) of receiver operating characteristic (ROC) curves were calculated. P <0.05 was considered statistically significant.
775 measurements were performed. 15 newborns were LGA. Fetal subcutaneous fat thickness (FSCFT) was not different at 23, 28 and 31 weeks between the macrosomic and non-macrosomic groups. In contrast, at 34 weeks, fetal soft tissues were significantly thicker for LGA newborns (P<0.05, table). Specificity and sensibility to detect macrosomia by a 34-week ultrasonography were respectively 78.6 and 66.7% for abdominal circumference, 71.4 and 93.3% for thigh FSCFT, 85.7 and 80.0% for upper arm FSCFT and, 71.4 and 86.7% for abdominal wall FSCFT. Any parameter was more powerful than the others. The best areas under ROC were found for abdominal circumference (=0.807), thigh FSCFT (=0.821), upper arm FSCFT (=0.855) and abdominal wall FSCFT (=0.821).
3rd trimester sonographic measurements of soft tissue may help to detect macrosomia in pregnancies with pre-gestational diabetes.