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

Leen Al-Hafez
1  Department of Obstetrics and Gynecology, Houston Methodist Hospital, Houston, Texas
,
Michael L. Pirics
1  Department of Obstetrics and Gynecology, Houston Methodist Hospital, Houston, Texas
,
Suneet P. Chauhan
2  Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas
› Author Affiliations
Funding There was no funding received for conducting this project.
Further Information

Publication History

24 October 2017

22 March 2018

Publication Date:
11 June 2018 (online)

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.

Note

The article was presented at the 2017 Central Association of Obstetricians and Gynecologists Annual Meeting in Scottsdale, Arizona.


Condensation

Among diabetics, the composite neonatal morbidity was higher if sonographic estimated fetal weight was > 90th percentile for gestational age (28%) than at 10 to 90th percentile (13%; OR, 2.65; 95% CI, 1.07–6.59).