The risk of large for gestational age across increasing categories of pregnancy glycemia

• Published in: American journal of obstetrics and gynecology Vol. 204; no. 3; pp. 240.e1 - 240.e6
• Main Authors: Ehrlich, Samantha F., MPH, Crites, Yvonne M., MD, Hedderson, Monique M., MPH, PhD, Darbinian, Jeanne A., MPH, Ferrara, Assiamira, MD, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.03.2011; Elsevier
• Subjects: Adolescent; Adult; Biological and medical sciences; Blood Glucose; Diabetes, Gestational - diagnosis; Diabetes, Gestational - epidemiology; Female; Fetal Macrosomia - epidemiology; Fetal Macrosomia - etiology; Gestational Age; Glucose Intolerance; glycemia; Gynecology. Andrology. Obstetrics; Humans; Hyperglycemia - complications; large for gestational age; Medical sciences; Middle Aged; Obstetrics and Gynecology; Pregnancy; Prevalence; Risk Factors; Young Adult; glycemia; pregnancy; large for gestational age; Pregnancy; Obstetrics; Gynecology; Gestational age; Glycemia; Risk factor
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2010.10.907

Objective We sought to estimate the risk of large for gestational age (LGA) across categories of glucose tolerance. Study Design In a cohort of 89,141 participants, women without gestational diabetes mellitus (GDM) were categorized by their screening and diagnostic test results; those with GDM were categorized as meeting the National Diabetes Data Group or only the American Diabetes Association (ADA) criteria. Multivariable logistic regression models estimated the risk of LGA; screening values 5.5-6.0 mmol/L comprised the referent. Results In women without GDM, the odds ratio for LGA was 1.89 (95% confidence interval [CI], 1.45–2.45) for fasting, 1.57 (95% CI, 1.31–1.89) for 1-hour, 1.60 (95% CI, 1.33–1.93) for 2-hour, and 1.62 (95% CI, 1.23–2.14) for 3-hour values meeting the ADA time point–specific thresholds. Conclusion For GDM identified in a 2-step procedure, our findings support the use of isolated abnormal fasting values according to the ADA threshold in identifying women who could benefit from treatment.