Third trimester glycemic profiles and fetal growth

Abstract

Diabetes is a common complication of pregnancy. Third trimester hyperglycemia has been associated in both gestational and pregestational diabetes with deviant fetal growth. Recent studies demonstrated that peak postprandial glucose levels in normal pregnancy are lower than previously thought. This finding could explain the lack of effectiveness reported by some investigators in achieving a rate of macrosomia similar to the general population. Among different possible blood glucose determinations, it appears that 1-hour postprandial as well as the overall mean blood glucose levels are the most closely correlated with fetal growth. It seems that a narrow window of glycemic levels is associated with optimal fetal growth because excessively tight glycemic control has been associated with increased incidence of small-for-gestational-age infants.