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

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Citation: American Journal of Perinatology. 33(13):1255-1261, 2016 NovPMID: 27398699Institution: MedStar Washington Hospital CenterDepartment: Obstetrics and Gynecology/Maternal-Fetal MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Birth Weight | *Diabetes Mellitus, Type 1/bl [Blood] | *Fetal Macrosomia/bl [Blood] | *Placenta/pa [Pathology] | *Pregnancy in Diabetics/bl [Blood] | Adult | Diabetes Mellitus, Type 1/co [Complications] | Female | Fetal Development | Fetal Macrosomia/et [Etiology] | Humans | Longitudinal Studies | Organ Size | Pregnancy | Pregnancy Trimester, First/bl [Blood] | Retrospective Studies | Young AdultYear: 2016ISSN:
  • 0735-1631
Name of journal: American journal of perinatologyAbstract: <b>Objective</b> 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. <b>Study Design</b> In a retrospective analysis of a cohort of women with T1DM, poor glycemic control was defined as glycohemoglobin A<sub>1</sub>(HbA<sub>1</sub>)> 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 (HbA<sub>1</sub><8.5% vs. HbA<sub>1</sub> > 8.5%) assessed the role of glycemic control on association between PW and LGA. <b>Results</b> 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 HbA<sub>1</sub> concentration<8.5%, there was no statistically significant association; however, with HbA<sub>1</sub>>8.5%, there was a strong association (OR=13.40, 95% CI: 3.31, 54.27). <b>Conclusion</b> 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.Copyright Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.All authors: Bowers K, Ehrlich S, Kawakita T, Khoury J, Mehta S, Miodovnik MFiscal year: FY2017Digital Object Identifier: Date added to catalog: 2017-05-24
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Journal Article MedStar Authors Catalog Article 27398699 Available 27398699

<b>Objective</b> 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. <b>Study Design</b> In a retrospective analysis of a cohort of women with T1DM, poor glycemic control was defined as glycohemoglobin A<sub>1</sub>(HbA<sub>1</sub>)> 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 (HbA<sub>1</sub><8.5% vs. HbA<sub>1</sub> > 8.5%) assessed the role of glycemic control on association between PW and LGA. <b>Results</b> 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 HbA<sub>1</sub> concentration<8.5%, there was no statistically significant association; however, with HbA<sub>1</sub>>8.5%, there was a strong association (OR=13.40, 95% CI: 3.31, 54.27). <b>Conclusion</b> 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.

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

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