Volume 11, Issue 4 (6-2013)                   IJRM 2013, 11(4): 325-0 | Back to browse issues page

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Eslamian L, Akbari S, Marsoosi V, Jamal A. Effect of different maternal metabolic characteristics on fetal growth in women with gestational diabetes mellitus. IJRM 2013; 11 (4) :325-0
URL: http://ijrm.ir/article-1-405-en.html
1- Department of Obstetrics and Gynecology, Tehran University of Medical Sciences, Tehran, Iran
2- Department of Obstetrics and Gynecology, Lorestan University of Medical Sciences, Khoramabad, Iran , soheilaakbari45@yahoo.com
Abstract:   (2834 Views)
Background: Fetal growth in diabetic pregnancies is a complex process and probably abnormalities in other metabolic pathways such as protein and lipid, as well as carbohydrate are responsible for delivering of macrosomic newborn.
Objective: The purpose of this study was to investigate the association between fetal growth and different maternal metabolic parameters in women with gestational diabetes mellitus (GDM) in comparison to control group.
Materials and Methods: This was a prospective cohort study conducted between March 2011 and May 2012, on 112 pregnant women with GDM and 159 healthy pregnant women. In order to determine of lipids or lipoproteins changes during pregnancy and to investigate any possible effects on fetal growth, lipid components, glucose and insulin levels were obtained in maternal serum three times in third trimester.
Results: Maternal serum glucose, total cholesterol (TC), low and high density lipoprotein (LDL-c, HDL-c) levels did not show any significant difference between two groups. While insulin, homeostasis model assessment-insulin resistance (HOMA-IR) and triglyceride (TG) values were detected to be significantly higher in the GDM cases especially after 32 weeks of gestation (p<0.001). After adjustment for confounding variables, maternal hypertriglyceridemia remained as a significant risk factor for delivering large for gestational age (LGA) newborns (p=0.04); and according to spearman test the increase of TG level was correlated with increase of insulin resistance and HOMA-IR (p<0.001, CI: 0.312).
Conclusion: Due to positive correlation of hypertriglyceridemia and hyperinsulinemia with newborn weight, it is possible to assume that elevated TGs levels in GDM cases is a reflection of variation in maternal insulin levels.
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Type of Study: Original Article |

References
1. Abourawi FI. Diabetes mellitus and pregnancy. Libyan J Med 2006; 1: 28-41. [DOI:10.3402/ljm.v1i1.4662]
2. Ben-Haroush A, Yogev Y, Hod M. Epidemiology of gestational diabetes and its association with type 2 diabetes mellitus. Diabetic Med 2004; 21: 103-113. [DOI:10.1046/j.1464-5491.2003.00985.x]
3. Koklu E, Akcakus M, Kurtoglu S, Koklu S, Yikilmaz A, Coskun A, et al. Aorticintima-mediathickness and lipid profile in macrosomic newborns. Eur J Pediatr 2007; 166: 333-338. [DOI:10.1007/s00431-006-0243-8]
4. Bener A, Saleh NM, Al-Hamaq A. Prevalence of gestational diabetes and associated maternal and neonatal complications in a fast-developing community: global comparisons. Int J Women's Health 2011; 3: 367-373. [DOI:10.2147/IJWH.S26094]
5. Kaaja RJ, Greer IA. Manifestations of chronic disease during pregnancy. JAMA 2005; 294: 2751-2757. [DOI:10.1001/jama.294.21.2751]
6. Metzger BE, Persson B, Lowe LP, Dyer AR, Cruickshank JK, Deerochanawong C, et al. Hyperglycemia and adverse pregnancy outcomes study: neonatal glycemia. Pediatrics 2010; 126: 1545-1552. [DOI:10.1542/peds.2009-2257]
7. Korucuoglu U, Biri A, Turkyilmaz E, Doga Yildirim F, Ilhan M, Hirfanoglu IM, et al. Glycemic levels with glucose loading test during pregnancy and its association with maternal and perinatal outcomes. Diabetes Res Clin Pract 2008; 80: 69-74. [DOI:10.1016/j.diabres.2007.10.028]
8. Gabbe SG, Graves CR. Management of diabetes mellitus complicating pregnancy. Obstet Gynecol 2003; 102: 857-868.
9. Flores-Le Roux JA, Chillaron JJ, Goday A, Puig De Dou J, Paya A, Lopez-Vilchez MA, et al. Peripartum metabolic control in gestational diabetes. Am J Obstet Gynecol 2010; 202: 568. e1-6.
10. Keshavarz M, Cheung NW, Babaee GR, Moghadam HK, Ajami ME, Shariati M. Gestational diabetes in Iran: incidence, risk factors and pregnancy outcomes. Diabetes Res Clin Pract 2005; 69: 279-286. [DOI:10.1016/j.diabres.2005.01.011]
11. Zawiejska A, Wender-Ozegowska E, Brazert J, Sodowski K. Components of metabolic syndrome and their impact on fetal growth in women with gestational diabetes mellitus. J Physiol Pharmacol 2008; 59: 5S-18S.
12. Lepercq J, Taupin P, Dubois-Laforgue D, Duranteau L, Lahlou N, Boitard C, et al. Heterogeneity of fetal growth in type 1 diabetic pregnancy. Diabetes Metab 2001; 27: 339-344.
13. Yessoufou A, Moutairou K. Maternal diabetes in pregnancy: early and long-term outcomes on the offspring and the concept of "metabolic memory". Exp Diabetes Res 2011; 2011: 218598. [DOI:10.1155/2011/218598]
14. Cox NJ. Maternal component in NIDDM transmission: how large an effect? Diabetes 1994; 43: 166-168. [DOI:10.2337/diab.43.1.166]
15. Stotland NE, Caughey AB, Breed EM, Escobar GJ. Corrigendum to "Risk factors and obstetric complications associated with macrosomia". Int J Gynecol Obstet 2004; 87: 220-226. [DOI:10.1016/j.ijgo.2004.08.010]
16. Khan NA. Role of lipids and fatty acids in macrosomic offspring of diabetic pregnancy. Cell Biochem Biophys 2007; 48: 79-88. [DOI:10.1007/s12013-007-0019-4]
17. Beardsall K, Diderholm BM, Dunger DB. Insulin and carbohydrate metabolism. Best Pract Res Clin Endocrinol Metab 2008; 22: 41-55. [DOI:10.1016/j.beem.2007.10.001]
18. Son GH, Kwon JY, Kim YH, Park YW. Maternal serum triglycerides as predictive factors for large-for-gestationalage newborns in women with gestational diabetes mellitus. Acta Obstet Gynecol Scand 2010; 89: 700-704. [DOI:10.3109/00016341003605677]
19. Aslan M, Celik O, Karsavuran N, Celik N, Dogan DG, Botan E, et al. Maternal serum and cord blood preptin levels in gestational diabetes mellitus. J Perinatol 2011; 31: 350-355. [DOI:10.1038/jp.2010.125]
20. Koukkou E, Watts GF, Lowy C. Serum lipid, lipoprotein and apolipoprotein changes in gestational diabetes mellitus: a cross-sectional and prospective study. J Clin Pathol 1996; 49: 634-637. [DOI:10.1136/jcp.49.8.634]
21. Knopp RH, Magee MS, Walden CE, Bonet B, Benedetti TJ .Prediction of infant birth weight by GDM screening tests. Importance of plasma triglyceride. Diabetes Care 1992; 15: 1605-1613. [DOI:10.2337/diacare.15.11.1605]
22. Carpenter MW, Coustan DR. Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol 1982; 144: 768-773. [DOI:10.1016/0002-9378(82)90349-0]
23. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972; 18: 499-502.
24. Hadlock FP, Harrist RB, Sharman RS, Deter RL, Park SK. Estimation of fetal weight with the use of head, body, and femur measurements-a prospective study. Am J Obstet Gynecol 1985; 151: 333-337. [DOI:10.1016/0002-9378(85)90298-4]
25. Ahlfors CE. New recommendations not very different from current practice. Pediatrics 1993; 91: 166-167.
26. Brizzi P, Tonolo G, Esposito F, Puddu L, Dessole S, Maioli M, et al. Lipoprotein metabolism during normal pregnancy. Am J Obstet Gynecol 1999; 181: 430-434. [DOI:10.1016/S0002-9378(99)70574-0]
27. Wiznitzer A, Mayer A, Novack V, Sheiner E, Gilutz H, Malhotra A, et al. Association of lipid levels during gestation with preeclampsia and gestational diabetes mellitus: a population-based study. Am J Obstet Gynecol 2009; 201: 482.e1-8. [DOI:10.1016/j.ajog.2009.05.032]
28. Hollingsworth DR, Grundy SM. Pregnancy-associated hypertriglyceridemia in normal and diabetic women, differences in insulin-dependent, non-insulin-dependent, and gestational diabetes. Diabetes 1982; 31: 1092-1097. [DOI:10.2337/diacare.31.12.1092]
29. Knopp RH, Chapman M, Bergelin R, Wahl PW, Warth MR, Irvine S. Relationships of lipoprotein lipids to mild fasting hyperglycemia and diabetes in pregnancy. Diabetes Care 1980; 3: 416-420. [DOI:10.2337/diacare.3.3.416]
30. Butte NF. Carbohydrate and lipid metabolism in pregnancy: normal compared with gestational diabetes mellitus. Am J Clin Nutr 2000; 71: 1256S-1261S. [DOI:10.1093/ajcn/71.5.1256s]
31. Enquobahrie DA, Williams MA, Qiu C, Luthy D.A. Early pregnancy lipid concentrations and the risk of gestational diabetes mellitus. Diabetes Res Clin Pract 2005; 70: 134-142. [DOI:10.1016/j.diabres.2005.03.022]
32. Montelongo A, Lasunción MA, Pallardo LF, Herrera E. Longitudinal study of plasma lipoproteins and hormones during pregnancy in normal and diabetic women. Diabetes 199; 41: 1651-1659.
33. Schaefer-Graf UM, Graf K, Kulbacka I, Kjos SL, Dudenhausen J, Vetter K, et al. Maternal lipids as strong determinants of fetal environment and growth in pregnancies with gestational diabetes mellitus. Diabetes Care 2008; 31: 1858-1863. [DOI:10.2337/dc08-0039]
34. Weiss PA, Kainer F, Haas J. Cord blood insulin to assess the quality of treatment in diabetic pregnancies. Early Hum Dev 1998; 51: 187-195. [DOI:10.1016/S0378-3782(97)00121-7]
35. Hultman K, Alexanderson C, Mannerås L, Sandberg M, Holmäng A, Jansson T. Maternal taurine supplementation in the late pregnant rat stimulates postnatal growth and induces obesity and insulin resistance in adult offspring. J Physiol 2007; 579: 823-833. [DOI:10.1113/jphysiol.2006.124610]
36. Kitajima M, Oka S, Yasuhi I, Fukuda M, Rii Y, Ishimaru T. Maternal serum triglyceride at 24--32 weeks' gestation and newborn weight in nondiabetic women with positive diabetic screens. Obstet Gynecol 2001; 97: 776-780. [DOI:10.1016/S0029-7844(01)01328-X]
37. Negrato CA, Jovanovic L, Tambascia MA, Calderon Ide M, Geloneze B, Dias A, et al.Mild gestational hyperglycaemia as a risk factor for metabolic syndrome in pregnancy and adverse perinatal outcomes. Diabetes Metab Res Rev 2008; 24: 324-330. [DOI:10.1002/dmrr.815]

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