FETAL ABDOMINAL OBESITY AND ADVERSE PERINATAL OUTCOMES IN OLDER AND OBESE PREGNANT WOMEN WITH NORMAL GLUCOSE TOLERANCE

Abstract

INTRODUCTION
We previously observed an increased prevalence of fetal abdominal obesity (FAO) in older with/without obese women with gestational diabetes mellitus. We investigated whether the increased risk of FAO was also present in older with/without obese women with normal glucose tolerance (NGT).

METHODOLOGY
We retrospectively reviewed 6,721 individuals with NGT, diagnosed by 50-g glucose challenge test (GCT) <140 mg/dL or normal subsequent 100-g oral glucose tolerance test if GCT ≥140 mg/dL. FAO was investigated ultrasonographically using ratios of gestational age with abdominal circumference, biparietal diameter, and femur length. The NGT subjects were divided into group 1 (age<35 years and pre-pregnant body mass index (BMI) <25 kg/m2 ), group 2 (age<35 & BMI≥25), group 3 (age ≥35 and BMI <25), and group 4 (age ≥35 and ≥25).

RESULTS
FAO ratios of groups 3 and 4 were significantly higher than group 1. Relative to group 1, the adjusted odds ratio for FAO in group 3 was 1.42 (95% CI; 1.17-1.73, p <0.05), and in group 4 was 1.90 (1.15-3.15, p <0.05). The odds ratio for large gestational age (LGA) at birth, relative to group 1, were 3.06 (1.96-4.77, p <0.005), 1.47 (1.16-1.86, p <0.005), and 2.82 (1.64-4.84, p <0.005) in group 2, 3 and 4, respectively. The odds ratio for primary cesarean delivery in group 3 was 1.33 (1.18-1.51, p <0.005).

CONCLUSION
Increased risk of FAO at 24-28 GW and the ensuing adverse perinatal outcomes of LGA and primary cesarean delivery were observed in the older with/without obesity but not in the younger/non-obese NGT women.