INCREASED MACROSOMIA AND PERINATAL MORBIDITY INDEPENDENT OF MATERNAL OBESITY AND ADVANCED AGE IN KOREAN WOMEN WITH GDM

OBJECTIVE - To examine the impact of gestational diabetes mellitus (GD M) on perinatal outcome in a setting where influences of maternal age and obesity would be minimal. RESEARCH DESIGN AND METHODS - A case-con trol study was done to compare the outcome of pregnancy in 65 women wi th GDM and 153 women with normal carbohydrate metabolism matched for a ge, height, and prepregnancy weight. RESULTS - The frequencies of pree clampsia and primary cesarean sections were higher and delivery was ea rlier in pregnancies complicated by GDM. Birth weight, symmetry index, and chest circumference were greater, and macrosomia and need for pho totherapy were more common in offspring of mothers with GDM. Cord-seru m C-peptide and insulin concentrations were higher in the infants of m others with GDM and were strongly correlated with birth weight and sym metry index. However, maternal age, prepregnancy weight, and prepregna ncy BMI were not correlated with birth weight. Postprandial glucose le vels during the first 2 weeks after diagnosis of GDM had associations with the infant's birth weight, symmetry index, and cord insulin conce ntration in the diet-treated patients with GDM.CONCLUSIONS - Antepartu m maternal glucose metabolism was significantly associated with fetal hyperinsulinemia and excessive fetal growth in relatively nonobese Kor ean women. These findings support a direct role for metabolic factors in the adverse outcomes in pregnancies complicated by GDM.