Sonographic Estimated Fetal Weight among Diabetics at ≥ 34 Weeks and Composite Neonatal Morbidity

Leen Al-Hafez; Michael L. Pirics; Suneet P. Chauhan

doi:10.1055/s-0038-1660433

American Journal of Perinatology Reports, Table of Contents

CC BY-NC-ND 4.0 · AJP Rep 2018; 08(02): e121-e127
DOI: 10.1055/s-0038-1660433

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Sonographic Estimated Fetal Weight among Diabetics at ≥ 34 Weeks and Composite Neonatal Morbidity

Authors

Leen Al-Hafez

¹Department of Obstetrics and Gynecology, Houston Methodist Hospital, Houston, Texas
Michael L. Pirics

¹Department of Obstetrics and Gynecology, Houston Methodist Hospital, Houston, Texas
Suneet P. Chauhan

²Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas

Abstract

Objectives The objective was to assess the composite neonatal morbidity (CNM) among diabetic women with sonographic estimated fetal weight (SEFW) at 10 to 90th versus >90th percentile for gestational age (GA).

Study Design The inclusion criteria for this retrospective study were singleton pregnancies at 34 to 41 weeks, complicated by diabetes, and that had SEFW within 4 weeks of delivery. Odds ratios (ORs) with 95% confidence intervals (CI) were calculated.

Results Among the 140 cohorts that met the inclusion criteria, 72% had SEFW at 10th to 90th percentile for GA, and 28% at >90th percentile. Compared with women with diabetes with last SEFW at 10th to 90th percentile, those with estimate > 90th percentile for GA had a significantly higher rate of CNM (13 vs. 28%; OR, 2.65; 95% CI, 1.07–6.59). Among 109 diabetic women who labored, the rate of shoulder dystocia was significantly higher with SEFW at >90th percentile for GA than those at 10th to 90th percentile (25 vs. 2%; p = 0.002); the corresponding rate of CNM was 29 versus 10% (p = 0.02).

Conclusion Among diabetic women with SEFW > 90th percentile for GA, CNM was significantly higher than in women with estimate at 10 to 90th percentile. Despite the increased risk of CNM, these newborns did not have long-term morbid sequela.

Keywords

diabetes - sonographic estimated fetal weight - composite neonatal morbidity

Full Text

References

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