Maternal diabetic control during early gestation, as measured by first-trimester fructosamine, significantly correlates with fetal growth and the development of macrosomia.
Should not yet change early-pregnancy glycemic monitoring; hypothesis-generating for fructosamine in macrosomia risk stratification.
We studied 30 diabetic pregnant women to compare serum fructosamine concentrations at different stages of gestation with fetal growth (as determined by ultrasonography) and with birth weight. Serum fructosamine levels in mothers of macrosomic infants were significantly higher (P less than .05) during the first trimester of pregnancy as compared with mothers of normal birth weight infants. Moreover, first-trimester fructosamine concentrations correlated significantly with birth weight (r = 0.68, P less than .001) and with ultrasound measurements of fetal abdominal circumference and femur length. The fetus destined to be macrosomic had an enlarged abdomen in the second trimester, often before 20 weeks' gestation. We conclude that maternal diabetic control during early gestation has an important influence on fetal growth and contributes to the development of fetal macrosomia.
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Roberts et al. (1988) studied this question.
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