[Correlation between amniotic fluid glucose concentration and amniotic fluid volume and neonatal birth weight in pregnancy complicated by gestational diabetes mellitus]

Abstract

Objective: To investigate the relationship between amniotic fluid glucose concentration, amniotic fluid volume and neonatal birth weight in gestational diabetes mellitus (GDM).

Methods: Two hundred and fifty-five singleton, normal term pregnant women were divided into three groups: GDM, gestational impaired glucose tolerance (GIGT) and normal pregnancy according to the results of a 50 g, 1 hour glucose challenge test (GCT) or of a 75 g oral glucose tolerance test (OGTT). There were 85 study subjects in each group. All women had GCT at 24 - 28 gestational weeks. When they had a positive GCT, in which glucose level was > or = 7.8 mmol/L, and < 10.6 mmol/L at 1 hour after oral 50 g glucose, they were required to have a 75 g OGTT. Amniotic fluid glucose concentration (AFG), amniotic fluid index (AFI), neonatal birth weight (NBW), maternal fasting glucose level (MFG) and umbilical venous glucose level (UvG) were compared in three groups. Statistical analysis of linear regression was done on these indices.

Results: (1) The mean AFG in group GDM was (1.30 +/- 0.71) mmol/L, which was significantly greater than that in group GIGT, (1.02 +/- 0.57) mmol/L and that in normal group, (0.90 +/- 0.58) mmol/L. There were significant differences among three groups (P < 0.01). (2) In group GDM, the mean AFI was (16.1 +/- 4.6) cm, which was slightly greater than that in group GIGT, (14.8 +/- 4.3) cm (P > 0.05), but was significantly higher than that in normal group, (12.7 +/- 3.2) cm (P < 0.01). (3) The NBW of group GDM was (3612 +/- 510) g, which was lower than that of group GIGT, (3694 +/- 490) g, and higher than that of normal group, (3487 +/- 458) g, but there were no significant differences among three groups (P > 0.05). (4) Among women with GDM, AFG was significantly correlated with AFI (r = 0.330, P = 0.002), NBW (r = 0.347, P = 0.001), MFG (r = 0.589, P < 0.01), and with UvG (r = 0.218, P = 0.045). But in group GIGT and normal group, AFG was only correlated with AFI. (5) In GDM group, the AFG, (1.02 +/- 0.50) mmol/L; AFI, (13.9 +/- 4.2) cm; and NBW, (3497 +/- 475) g in women who had ideal blood glucose level were significantly lower than that in women whose blood glucose levels were not well-controlled [AFG, (1.92 +/- 0.76) mmol/L, AFI, (16.4 +/- 4.4) cm, NBW, (3869 +/- 481) g (P < 0.01, P < 0.05, P < 0.01)], and the mean values of these three indices were close to those of the control group.

Conclusion: In the cohort with GDM, there were correlations between AFG, AFI, and NBW. The results show that an active management could significantly improve the prognoses of the diabetes mothers and their fetuses.