Placental Weight in Pregnant Women with Type 1 Diabetes Mellitus: The Association with Fetal Growth

Supal Mehta; Jane Khoury; Menachem Miodovnik; Tetsuya Kawakita; Shelley Ehrlich; Katherine Bowers

doi:10.1055/s-0036-1585055

American Journal of Perinatology, Table of Contents

Am J Perinatol 2016; 33(13): 1255-1261
DOI: 10.1055/s-0036-1585055

Original Article

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

Placental Weight in Pregnant Women with Type 1 Diabetes Mellitus: The Association with Fetal Growth

Supal Mehta

¹Department of Biological Sciences, Loyola University, Chicago, Illinois

²Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

,

Jane Khoury

²Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

³Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

,

Menachem Miodovnik

⁴Pregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland

,

Tetsuya Kawakita

⁵MedStar Washington Hospital Center, Washington, District of Columbia

,

Shelley Ehrlich

²Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

,

Katherine Bowers

²Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

› Author Affiliations

Abstract

Objective To determine the association between placental weight (PW) and large for gestational age (LGA) in women with type 1 diabetes mellitus (T1DM) and whether glycemic control modifies the association.

Study Design In a retrospective analysis of a cohort of women with T1DM, poor glycemic control was defined as glycohemoglobin A₁(HbA₁)≥ 8.5% (≥2 standard deviations [SD] above mean), and LGA as birth weight > 90th percentile, according to gestation, race, and sex. Multivariable logistic regression was used for analysis. Stratified analyses (HbA₁ < 8.5% vs. HbA₁ ≥ 8.5%) assessed the role of glycemic control on association between PW and LGA.

Results PW in 302 pregnancies was positively associated with LGA (first vs. fourth quartile of PW; odds ratio [OR] = 9.56; 95% confidence interval [CI]: 4.14–22.08). Association varied significantly by glycemic control in the first trimester, but not in the second and third trimesters. For women with first trimester HbA₁ concentration < 8.5%, there was no statistically significant association; however, with HbA₁≥ 8.5%, there was a strong association (OR = 13.40, 95% CI: 3.31, 54.27).

Conclusion There was a significant positive association between PW and LGA in infants of women with T1DM, particularly evident in pregnancies with poor glycemic control during the first trimester, highlighting the importance of achieving good glycemic control early in gestation.

Keywords

placental weight - type 1 diabetes mellitus - large for gestational age - glycemic control

Full Text

References

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