The effect of maternal metabolic factors and lipid profile on birth weight in pregnant women with gestational diabetes and normal glucose tolerance

INTRODUCTION: The objective of the study is to investigate the impact of maternal metabolic syndrome parameters and lipid profiles on fetal growth in pregnancies with gestational diabetes and with normal glucose tolerance. The second aim was to compare the metabolic profiles of pregnant women with gestational diabetes mellitus and with normal glucose tolerance.
METHODS: Pregnant women who applied for an oral glucose tolerance test were recruited and followed up prospectively. They were also examined for metabolic syndrome, including serum lipid profile between 24th and 28th weeks. The group diagnosed with gestational diabetes and those with normal glucose tolerance were compared in terms of obesity, hypertension, serum lipid profile, and neonatal birth weight. Hypertriglyceridemic and normotriglyceridemic patients were compared regarding maternal metabolic syndrome criteria and neonatal birthweight.
RESULTS: Diabetic pregnant women had significantly higher body mass index (BMI) and triglyceride levels and lower high-density lipoprotein (LP) levels than non-diabetics. The hypertension rate was also higher; however, it was not statistically significant. Those with hypertriglyceridemia had higher BMI, hemoglobin (HbA1c) level, and neonatal birth weight in the diabetic group, whereas triglyceride level did not impact neonatal birthweight in non-diabetic patients. Obesity, high HbA1c, and triglyceride levels, and low high-density LP levels were the parameters leading to fetal macrosomia in gestational diabetes.
DISCUSSION AND CONCLUSION: Increased accumulation of glucose toward the fetus is not the only mech-anism of macrosomia. Parameters of metabolic syndrome affect fetal growth concomitantly. Diabetic women should be evaluated in the context of metabolic syndrome.