Background: Fetal abdominal obesity (FAO) was already observed at the time of diagnosis of GDM in our previous study. We investigated whether fetuses of women with hyperglycemia milder than GDM showed accelerated abdominal growth, leading to adverse pregnancy outcomes.
Methods: 7,569 singleton pregnant women were universally screened using a 50-g glucose challenge test (GCT) and diagnosed by a 3-h 100-g oral glucose tolerance test (OGTT) with GDM, one value abnormality (OVA), and normal glucose tolerance (NGT, NGT1: GCT negative, NGT2: GCT positive & OGTT negative). Fetal abdominal growth at 24-28 gestational weeks was assessed by fetal abdominal overgrowth ratios (FAORs) of the ultrasonographically estimated gestational age (GA) of abdominal circumference per biparietal diameter, femur length, and actual GA by the last menstruation period, respectively. FAO was defined as FAOR ≥90th percentile.
Results: FAORs were significantly higher in OVA subjects compared to NGT subjects, but not in NGT2 subjects. The prevalence of LGA at birth and primary cesarean delivery rates were significantly higher in OVA (9.8 and 29.7%) than in NGT (5.1% and 21.5%, p<0.05), especially in OVA subjects with FAO (33.3% and 66.7%).
Conclusion: Fetal abdominal growth was accelerated in OVA subjects and OVA subjects with FAO were strongly associated with adverse pregnancy outcomes.