Clinical Trial: Maternal Hypoglycemia and Placental Pathology

Study Status: Completed
Recruit Status: Completed
Study Type: Observational

Official Title: Maternal Hypoglycemia During One Hour Glucose Tolerance Test as a Risk for Decreased Placental Weight and Placental Pathology

Brief Summary: The purpose of this retrospective pilot study is to assess the association of maternal hypoglycemia during the one hour glucose tolerance test with decreased placental weight and identifiable placental pathology. We hypothesize that a decreased one hour glucose tolerance test is a risk factor for decreased placental weight, an increased fetal to placental weight ratio, and other identifiable placental pathology.

Detailed Summary:

There have been several studies linking hyperglycemia during pregnancy to adverse perinatal outcomes such as macrosomia, fetal cardiac defects, and shoulder dystocia. However, there have only been a few studies addressing the effects of hypoglycemia on perinatal outcomes. Several of these studies have shown an increased risk of intrauterine growth restriction (IUGR) with maternal hypoglycemia particularly during the glucose tolerance test (GTT).3-6 However, many of these studies have not taken into account comorbid factors or have conflicting findings.3-6 IUGR is defined as infant birth weights below the tenth percentile when the baby is otherwise genetically normal. The purpose of this retrospective pilot study is to assess the association of maternal hypoglycemia during the one hour glucose tolerance test with decreased placental weight and identifiable placental pathology. We hypothesize that a decreased one hour glucose tolerance test is a risk factor for decreased placental weight, an increased fetal to placental weight ratio, and other identifiable placental pathology.

Abell et al. found that maternal hypoglycemia during the one hour GTT was associated with decreased birth weights and intrauterine growth restriction (IUGR). However, this study made no comment on the effect of confounding factors such as tobacco use, history of gestational diabetes, or maternal BMI. Both Sokol et al and Langer et al revealed a link between decreased maternal response during the third trimester GTT and IUGR, although in the Sokol study, each pregnancy had one known risk factor for gestational diabetes. Conversely, several more recent papers have reported that maternal hypoglycemia is not predictive of IUGR or poor perinatal outcomes. -8 Consequently, the effect maternal hypoglycemia during the oral GTT is unclear. The placenta is viewed as a reflection of the intrauterine environment
Sponsor: Oklahoma State University Center for Health Sciences

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Information By: Oklahoma State University Center for Health Sciences

Dates:
Date Received: January 31, 2008
Date Started: December 2007
Date Completion:
Last Updated: July 8, 2008
Last Verified: July 2008