Endocrine Abstracts

Background: A fetal macrosomia is the most frequent complication of gestational diabetes mellitus (GDM) in Lithuania. The aim of our study was to assess the predicting factors of fetal macrosomia in GDM.

Methods: Retrospective data analysis of 3 547 women who delivered in Vilnius University Hospital Santariskiu Klinikos in 2015 was performed. Documented GDM risk factors were obtained from medical records and electronic database. Newborns over 4000 g birth weight were defined as macrosomic cases. Comparisons were made between women who delivered healthy (group I) and macrosomic (group II) newborns. Multiple regression analysis was used to calculate the odds ratio (OR) and their 95% confidence intervals (CI).

Results: Two hundred and thirteen women (6%) out of 3547 had GDM. Fifty of them (24.39%) delivered macrosomic newborns. There were no age difference between the groups (31.7 vs 32.1 kg), but women had higher pre-pregnancy body weight (78.3 vs 67.0 kg, P<0002) and BMI (29.1 vs 25.7, P<0.004) and GDM was diagnosed later (31.0 vs 29.7 week, P<0.048) in group I compared to group II. Factors associated with increased risk of fetal macrosomia were maternal pre-pregnancy BMI (OR1.11 [1.0–1.2], P<0.05), previous fetal macrosomia (OR 8.04 [3.5−18.4], P<0.05), previous polyhydramnion (OR 4.04 [1.3–12.7], P<0.05), time of GDM diagnosis (OR 1.11 [1.0–1.2], P<0.05), and gestational age (OR 1.35 [1.0–1.8], P<0.05). In a multiple regression pre-pregnancy body weight and previous fetal macrosomia remained the only predictors for increased risk of neonatal macrosomia.

Conclusions: Neonatal macrosomia prevention remains a challenge. According to our study pre-pregnancy body weight and previous fetal macrosomia are associated with increased risk of fetal macrosomia of current pregnancy. This finding provides insights for the prevention of macrosomia development in women with GDM.