IS MACROSOMIA ASSOCIATED WITH POOR GLYCEMIC CONTROL IN DIABETIC PREGNANCY

The study aimed to determine the influence of glucose control during p regnancy on the incidence of macrosomia in the infants of mothers with insulin-dependent diabetes. The prevalence of macrosomia was determin ed in pregnancies of all such women attending the City Hospital Nottin gham, between July 1987 and July 1993, where it is policy for diabetic patients to aim during pregnancy for preprandial capillary glucose le vels of less than 6.0 mmol l(-1), and postprandial glucose levels of l ess than 8.0 mmol l(-1). Macrosomia was defined as a birthweight great er than 90th centile using a computer model which takes into account a ll the major determinants of birthweight. Twelve of 29 infants were ma crosomic, which was greater than expected (p < 0.01). During pregnancy there was no difference in mean seven point glucose profiles between those mothers with normal weight babies and those with macrosomia, but fructosamine levels at booking were significantly higher in the latte r 2.5 (1.9-2.9) vs 2.2 (1.2-3.0); p < 0.05. These data confirm other s tudies and suggest that the incidence of macrosomia may be reduced by tighter control of diabetes at conception and in the first trimester, but to a lesser extent during later pregnancy.