الفهرس 
Gestational DiabetesOnly 14 pages are availabe for public view
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Abstract
This prospective cohort study was conducted at Ain Shams University Maternity Hospital in the period from January 2020 till August 2021 to determine the association between the level of maternal triglycerides (TGs) and fetal macrosomia in pregnant women of different BMI subgroups with gestational diabetes mellitus (GDM). One hundred seventy pregnant women diagnosed with GDM and were allocated into two groups after measuring TG level group (A): diabetic pregnant female suffering from dyslipidemia and group (B): Diabetic pregnant female with normal lipid profile. selection and withdrawal of patients was according to the following criteria:
Inclusion criteria:
1) Age: 18-40 years old.
2) Live-born singleton pregnancy.
3) Confirmed to have Gestational Diabetes mellitus by oral glucose tolerance test.
4) Controlled GDM according to HbA1C (< 6%).
5) BMI ranging from 20-30 kg/m2.
6) A clear gestational age (24 weeks-35 weeks).
7) Signed informed consent.
8) Normal doppler studies indicating no vasculopathy.
9) Delivery between 37-40weeks.
Exclusion criteria:
1) We excluded women suffering from any medical disorder rather than GDM to eliminate the influences of these diseases on lipid metabolism and infant birth weight.
2) Mothers who delivered before 37 weeks of gestation.
3) BMI less than 20 kg/m2 or more than 30 kg/m2.
4) Cases of congenital fetal malformation or multifetal gestation.
5) Cases of abnormal doppler values denoting underlying vasculopathy.
6) Acute or chronic infections.
7) Pregestational diabetes.
8) Uncontrolled GDM according to HbA1C (>6%)
9) Diagnosed DM before 20 weeks.
Clinical examination was done after history taking and fulfillment of inclusion and exclusion criteria, including general abdominal and pelvic examination.
Maternal metabolic parameters included Serum glucose by oral glucose tolerance test and Blood Serum TG samples were drawn once between 28 and 35 weeks of pregnancy.
The information of neonatal delivery, sex, birth weight and height, gestational age, mode of delivery, and perinatal outcomes were gathered.
Statistical analysis of current results showed that there was no statistically significant difference (p-value > 0.05) between studied groups as regard age and gestational age, while BMI was significantly higher in the dyslipidemic group 25.4 - 28.8 vs.23.8 - 26.6 kg/m2 (p-value < 0.001). No statistically significant difference (p-value > 0.05) was noted between studied groups as regard OGTT (FBS, 1 hour, 2 hours & 3 hours). Serum triglycerides (TGs), birth weight, and macrosomia were significantly higher in the dyslipidemic group compared with the normal group.
Logistic regression analysis showed that TG could be used as a predictive factor for macrosomia (B = 0.019. SE = 0.005, p-value < 0.001, Odds = 1.02 & 95% CL = 1.01 - 1.02). Also, ROC curve showed that serum TG can be used to predict macrosomia at a cutoff level of >303.5 mg/dl, with 74.5% sensitivity, 73.3% specificity, 73.6% PPV and 74.2% NPV (AUC = 0.84 & p-value < 0.001).