ArticleActa obstetricia et gynecologica Scandinavica2022
Ultrasound predictors of adverse outcome in pregnancy complicated by pre-existing and gestational diabetes.
Article in Acta obstetricia et gynecologica Scandinavica, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed, 11 citations in OpenAlex.
- Comparison of cerebro-placental-uterine ratio between patients with gestational diabetes mellitus and healthy pregnant women: A prospective tertiary center observational study.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Observational
- Sonographic Predictors of Adverse Perinatal Outcomes in Pregnancies Complicated by Hyperglycaemia.Journal of obstetrics and gynaecology of India · 2025Article
- Fetal biometry measurements in diabetic pregnant women and neonatal outcomes.Obstetrics & gynecology science · 2025Article
- Fetomaternal Doppler sonography for the prediction of perinatal outcome in term pregnancies complicated by gestational diabetes mellitus: does it have potential?Ultrasound international open · 2025Article
- Neonatal outcomes and rationale for timing of birth in perinatal diabetes: a retrospective cohort study.American journal of obstetrics & gynecology MFM · 2023Article
- Prognostic Accuracy of Antenatal Doppler Ultrasound Measures in Predicting Adverse Perinatal Outcomes for Pregnancies Complicated by Diabetes: A Systematic Review.AJOG global reports · 2023Review
- Ultrasound predictors of adverse outcome in pregnancy complicated by pre-existing and gestational diabetes.Acta obstetricia et gynecologica Scandinavica · 2022Article
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Authors and funding
6 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
introductionUltrasound assessment of fetuses subjected to hyperglycemia is recommended but, apart from increased size, little is known about its interpretation, and the identification of which large fetuses of diabetic pregnancy are at risk is unclear. Newer markers of adverse outcomes, abdominal circumference growth velocity and cerebro-placental ratio, help to predict risk in non-diabetic pregnancy. Our study aims to assess their role in pregnancies complicated by diabetes. MATERIAL AND
methodsThis is a retrospective analysis of a cohort of singleton, non-anomalous fetuses of women with pre-existing or gestational diabetes mellitus, and estimated fetal weight at the 10th centile or above. Gestational diabetes was diagnosed by selective screening of at risk groups. A universal ultrasound scan was offered at 20 and 36 weeks of gestation. Estimated fetal weight, abdominal circumference growth velocity, presence of polyhydramnios, and cerebro-placental ratio were evaluated at the 36-week scan. A composite adverse outcome was defined as the presence of one or more of perinatal death, arterial cord pH less than 7.1, admission to Neonatal Unit, 5-minute Apgar less than 7, severe hypoglycemia, or cesarean section for fetal compromise. A chi-squared test was used to test the association of estimated fetal weight at the 90th centile or above, polyhydramnios, abdominal circumference growth velocity at the 90th centile or above, and cerebro-placental ratio at the 5th centile or below with the composite outcome. Logistic regression was used to assess which ultrasound markers were independent risk factors. Odds ratios of composite adverse outcome with combinations of independent ultrasound markers were calculated.
resultsA total of 1044 pregnancies were included, comprising 87 women with pre-existing diabetes mellitus and 957 with gestational diabetes. Estimated fetal weight at the 90th centile or above, abdominal circumference growth velocity at the 90th centile or above, cerebro-placental ratio at the 5th centile or below, but not polyhydramnios, were significantly associated with adverse outcomes: odds ratios (95% confidence intervals) 1.85 (1.21-2.84), 1.54 (1.02-2.31), 1.92 (1.21-3.30), and 1.53 (0.79-2.99), respectively. Only estimated fetal weight at the 90th centile or above and cerebro-placental ratio at the 5th centile or below were independent risk factors. The greatest risk (odds ratio 6.85, 95% confidence interval 2.06-22.78) was found where both the estimated fetal weight is at the 90th centile or above and the cerebro-placental ratio is at the 5th centile or below.
conclusionsIn diabetic pregnancies, a low cerebro-placental ratio, particularly in a macrosomic fetus, confers additional risk.
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