DOES EARLY GROWTH DELAY OCCUR IN DIABETIC PREGNANCY

Objective To identify the date of ovulation in pregnant women with Typ e 1 diabetes in order to assess the validity of the concept of early g rowth delay. Design Identification of ovulation by measurement of urin ary luteinising hormone and assessment of fetal growth using ultrasoun d scan. Setting Diabetic pre-pregnancy and antenatal clinic in a teach ing hospital. Subjects Twenty women with Type 1 diabetes who had atten ded a pre-pregnancy clinic. Measures Urinary LH, by laboratory and kit methods, during conception cycles. Human chorionic gonadotrophin meas ured in early pregnancy. Early ultrasound scans by a single observer b lind to menstrual and ovulation dates. Outcome Gestation calculated fr om ovulation date and gestation estimated from menstrual dates, compar ed with gestation at age indicated by early ultrasound scan. Results W hen the date of ovulation was identified in 20 women with Type 1 diabe tes there was no evidence of growth delay in any pregnancy. When gesta tion was estimated from menstrual dates there was apparent early growt h delay in six pregnancies. Conclusion This study, together with other s discussed, indicates that early growth delay is probably an artefact of incorrectly estimated ovulation date.