Role of third-trimester serum triglycerides in the prediction of large-for-gestational-age (LGA) in pregestational and gestational diabetes mellitus.

Introduction: Still there is increasing tendency to macrosomia in fetuses of diabetic women despite
good diabetic control. Hyperglycemia is not only the responsible factor of undue fetal weight in 
pregnant women. The study intent was to find out whether maternal hyperlipidemia is responsible for 
prevalence of large for gestational age (LGA) in newborns of women with pregestational (PGDM) 
and gestational diabetes (GDM). Material and methods: This prospective observational, singlecenter study was executed in women with PGDM and GDM. Data were gathered in the (35th–38th
weeks). Results: Among 216 pregnant women recruited in the analysis, 45 cases (20.8%) delivered 
average-for-gestational-age (AGA) newborns, all of them delivered normally. The remaining 171 
cases (79.2%) newborns were large for gestational age (LGA), 100 of them were delivered by C.S and 
other 71 were delivered normally. The preponderance of LGA newborns was significantly higher in 
women with hypertriglyceridemia. Maternal TG and cholesterol levels were significantly higher in the 
group of LGA than in the AGA group (374.73±103.16) vs (242.23±88.99), p=0.00, and 
(249.93±38.85) vs (187.54±22.95), p <0.0001 respectively. While HDL was significantly lower in the 
LGA group than in the AGA group (53.95 ± 11.78) vs (66.61 ± 9.01), p <0.0001. Maternal 
Cholesterol, HDL and triglycerides levels tended to be correlated with newborn birth weight with 
sensitivity 80%, 86.7%, 86.7%, specificity 87.7%, 87.7%, 70.1% and cut off value >213.5mg/dl, 
<61.3mg/dl, >345mg/dl respectively. Conclusions: Decreased HDL and increased triglycerides levels 
in pregnant women with PGDM and GDM might chip in the evolution of fetal macrosomia or LGA.