Small-for-gestational-age foetuses characteristics and outcome in pregnancies complicated by gestational diabetes

Objective. The aim of the study was to define small-for-gesta­tional-age (SGA) foetuses characteristics in pregnancies com­plicated by gestational diabetes (GDM) and to evaluate the possible underlying haemodynamic changes.
Materials and Methods. We enrolled 112 women with sin­gleton pregnancies complicated by SGA foetuses, 30 of them had GDM while 82 did not. Maternal height and weight were considered at the admission time while haemodynamic as­sessment with USCOM was performed in both groups in the third trimester before delivery. To assess foetal outcomes, we considered the STv of CTG performed in admission and Foe­tal Birth Weight.
Results. GDM group had an higher BMI (29.3 ± 6.2 vs 25.9 ± 3.9; p = 0.0008), lower STv (7.5 ± 2.9 vs 9.4 ± 2.7; p = 0.003) and a lower Foetal Birth weight (2,105 ± 514.2 vs 2,350 ± 534.2; p = 0.03) with a higher proportion of PFS < 5° pc (80% vs 59.7%; p = 0.05) despite of the non-diabetic group. In pregnancies com­plicated by GDM there were twice as many cases of hyperten­sion and double the use of nitroderivative therapy. Haemody­namics features were similar in the two groups.
Conclusions. SGA foetuses of diabetic women have a worse outcome risk by presenting at delivery with lower foetal weight and STv both of which data would seem to suggest that in pregnancies with GDM, SGA foetuses have a higher degree of severity than in pregnancies not complicated by GDM.