Maternal postprandial glucose levels and infant birth weight: the Diabetes in Early Pregnancy Study

Article Abstract:

Diabetic women have fetuses with macrosomia (birth weights that place them above the 90th percentile) more often than nondiabetics; these infants are at risk for increased complications and mortality before and after birth. Little is known about the reasons for increased fetal macrosomia among diabetics, nor is the significance of maternal glucose (blood sugar) levels for the growth pattern of the fetus well understood. To learn more about diabetes and the outcome of pregnancy, the Diabetes in Early Pregnancy Study was carried out at several medical centers, identifying pregnant diabetic women as early as possible in gestation. The glucose levels and other parameters related to diabetes were monitored for the 323 women throughout pregnancy; a control group of 361 nondiabetic control women was also included. Infants were placed in percentile categories according to birth weight. Results showed that more infants of diabetic mothers (28.5 percent) than controls (13.1 percent) were at or above the 90th percentile for weight. Nonfasting blood glucose level (taken when the patient has eaten normally) for the first and third trimesters was strongly correlated with infant birth weight, and glycosylated hemoglobin level (which reflects blood glucose over a longer time period) for the third trimester was most strongly correlated with birth weight. The fasting blood glucose level in the second trimester only was significantly correlated with birth weight. A discussion is presented of the ways that elevations in maternal blood glucose levels could cause increased fetal weight. The importance of glucose levels in the first and second trimesters was interesting, since fetal fat is known to proliferate later in pregnancy. Changes early in pregnancy of at-risk mothers may pave the way for subsequent abnormality of the beta-cells (the pancreatic cells that secrete insulin), leading to excess fat deposition. Diabetic women at risk for having macrosomic infants should be monitored for glycosylated hemoglobin and nonfasting blood glucose levels throughout pregnancy, not just for fasting glucose levels, which are commonly used in clinical practice. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Causes of, Blood sugar, Blood glucose, Fetal macrosomia

---

Sweet success, but an acid aftertaste?

Article Abstract:

Infant mortality has decreased significantly as a result of intensive efforts to normalize blood glucose (sugar) levels in pregnant diabetic women, but bad outcomes still occur. Diabetic control is associated with lower blood glucose levels, which, in turn, have been implicated in certain birth defects. However, research findings concerning this point have not been consistent. A study in the September 26, 1991 issue of The New England Journal of Medicine reports a long-term effect of some maternal metabolic variables on children's intelligence. The variables of particular interest were those associated with the production of ketones, substances produced during fasting in normal pregnant women as a consequence of fat breakdown. Excess levels of ketones are known to be harmful to the fetus, but the effects of moderately high levels, which often occur in diabetics, are unknown. In the study presented, no relation was found between maternal hypoglycemia (low levels of blood sugar) and intelligence scores, but inverse correlations were found between levels of beta-hydroxybutyrate in the third trimester of pregnancy and children's mental-development indexes at the age of two. Furthermore, inverse correlations were found between maternal third-trimester concentrations of both beta-hydroxybutyrate and free fatty acids and the average of scores on an intelligence test given at the ages of three, four, and five. It is thus possible that low insulin levels, which cause increased levels of beta-hydroxybutyrate, could lead to poorer outcomes. This study and related research provides important data for determining optimal metabolic control in pregnant women with diabetes. What is needed is the application of such results to the development of appropriate treatments. (Consumer Summary produced by Reliance Medical Information, Inc.)

Child development, Insulin, Prenatal influences, Intelligence (Psychology), Intellect, editorial

---

Comparative evaluation of uterine response to exercise on five aerobic machines

Article Abstract:

The safety of using exercise equipment during pregnancy has not been established. The effect that exercising on aerobic exercise machines has on the activity of the uterus was studied in 12 healthy women in their last three months of pregnancy. The women participated in a exercise workout performed on an upper body ergometer, a rowing machine, a bicycle ergometer, a motorized treadmill and a recumbent bicycle. The activity of the uterus, heart rate and blood pressure were measured continuously throughout the 15 minute workouts. The evaluations were obtained from 207 workouts. When the workloads were equal, the uterine activity was increased in 50 percent of the sessions on the bicycle ergometer, 40 percent of the sessions on the treadmill and 10 percent of the sessions on the rowing machine. The uterine activity was not increased when the upper body ergometer and the recumbent bicycle were used. The effect of uterine activity on the outcome of the pregnancy remains controversial. Upper body ergometry and recumbent bicycling may be safer exercises for pregnant women. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Safety and security measures, Aerobic exercises, Women's fitness, Exercise equipment, Exercise bicycles

Similar abstracts:

• Abstracts: Management of women with one abnormal oral glucose tolerance test value reduces adverse outcome in pregnancy. The postprandial glucose profile in the diabetic pregnancy
• Abstracts: Maternal serum alpha2-macroglobulin and fetal growth retardation
• Abstracts: Maternal serum alpha-fetoprotein screening for fetal Down syndrome in the United States: results of a survey. Lack of an association between late fetal death and antiphospholipid antibody measurements in the second trimester
• Abstracts: Incidence of adverse events and negligence in hospitalized patients: results of the Harvard Medical Practice Study I
• Abstracts: Warning symptoms, uterine contractions, and cervical examination findings in women at risk of preterm delivery

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.