Endocrine Abstracts

Introduction: Gestational diabetes (GD) is associated with a significantly higher risk of perinatal complications. It has been suggested that third-trimester (3thT) foetal abdominal circumference (_fAC) determination is an important predictor of macrossomia and large for gestational age (LGA).

Aims: The purpose of this study was to evaluate the association between the 3thT _fAC percentile with birthweight (BW) and adverse neonatal outcomes in a cohort of women with GD.

Methods: We retrospectively analysed the _fAC percentile of the 3thT ultrasound screening in pregnant women with GD within a 2 years period in a Central University Hospital. We enrolled 268 pregnant women with singleton pregnancy undergoing routine fetal biometry after 28 weeks. The relationship between _fAC and BW was explored using the Spearman’s correlation and among _fAC percentile groups (<50; ≥50) and adverse neonatal outcomes using the Fisher’s exact test.

Results: The study included 268 singleton pregnancies; the median maternal age was 33 years old (range, 17–52) with a median delivery week of 39 weeks (range, 29–41). The median BW was 3165 g (range, 1370–4450), 3thT ultrasound gestational age measurement 36 weeks (range, 29–40) and _fAC percentile 50 (range, 1–100). Neonatal outcomes prevalences: neonatal morbidity compositum (n=67; 25%), small for gestational age (n=25; 9.3%), LGA (n=24; 9.0%), macrossomia (n=12; 4.5%), and neonatal hypoglycaemia (n=5; 1.9%). The macrossomia and LGA rates were greater in the _fAC percentile group ≥50 compared to <50 (91.7% vs 8.3% and 95.8 vs 4.2% respectively) (P<0.05). There was no significant difference in neonatal hypoglycaemia rate between groups (80% vs 20%, P=0.384). We documented a strong positive correlation between _fAC and BW: R=+0.626, P<0.001 (R²=0.392).

Conclusions: The intrapartum _fAC measurement was useful in screening fetal macrossomia and LGA. These results suggest that _fAC measured by ultrasound can help to predict the BW and seems to be a valuable parameter to be included when we evaluate a gestational diabetic pregnant woman.