Insulin therapy in pregnant women with insulin-dependent diabetes mellitus(IDDM): Effects on anthropometric features of full-term infants

The aim of this study was to assess what degree of maternal metabolic contr ol in women with IDDM is associated with normal fetal growth and neonatal b ody proportions in a group of full-term infants. We investigated the anthro pometric characteristics of 98 singleton term infants born to 98 women with IDDM. The IDDM mother-infant pairs were divided into three groups on the b asis of the daily glucose levels reached during the 2(nd) and the 3(rd) tri mesters of pregnancy: average daily glucose level during the 2(nd) and 3(rd ) trimester less than or equal to 95 mg/dl (Group 1, n=37); average daily g lucose level during the 2(nd) trimester > 95 mg/dl and during the 3(rd) tri mester of less than or equal to 95 mg/dl (Group 2, n=37); average daily glu cose level during the 2(nd) and the 3(rd) trimester > 95 mg/dl (Group 3, n= 24). Control group: 1,415 mother-infant pairs with term singleton pregnanci es and normal glucose challenge test. Infants of mothers in Group 1 were si milar to those of the control group in birth weight and in other anthropome tric parameters. In contrast, offspring of diabetic mothers of Groups 2 and 3 showed an increased incidence of large-for-gestational age (LGA) infants , significantly greater means of ponderal index and thoracic circumferences and significantly smaller cranial/thoracic circumference ratios with respe ct to the control group. The results of our study suggest that, in diabetic pregnancies, only overall daily glucose values less than or equal to 95 mg /dl throughout the 2(nd) and the 3(rd) trimesters can avoid alterations in fetal growth.