Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Predictive value of fetal hepatic biometry for birth weight and cord blood markers in gestational diabetes

Journal of Perinatology volume 36, pages 723–728 (2016)Cite this article

Subjects

Abstract

Objective:

The objective of this study is to evaluate third-trimester fetal liver biometry, to predict birth weight and cord markers at birth in diabetic pregnancies.

Study Design:

Fetal liver biometry (liver diameters, area and volume) was obtained between 32 and 34 weeks. A blood sample was obtained from cord after birth. Receiver operating characteristic (ROC) curve models were evaluated for 75th and 90th birth weight percentile. Univariate and multivariate models were used.

Result:

All the hepatic diameters, area and sectional volume demonstrated significant differences in both birth weight percentile ⩾75 and ⩾90. All ROC curves showed significant values. A significant association was observed for all measurements with birth weight. In multivariate model, liver area volume gave significant values for predicting birth weight. Cord leptin, c-peptide and ferritin were related to fetal hepatic size.

Conclusion:

The hepatic changes in gestational diabetes were valid to predict birth weight and metabolic changes at birth.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Nyberg DA, Abuhamad A, Ville Y . Ultrasound assessment of abnormal fetal growth. Semin Perinatol 2004; 28 (1): 3–22.

    Article  Google Scholar 

  2. Tongprasert F, Srisupundit K, Luewan S, Tongsong T . Normal length of the fetal liver from 14 to 40 weeks of gestational age. J Clin Ultrasound 2011; 39 (2): 74–77.

    Article  Google Scholar 

  3. Perovic M, Gojnic M, Arsic B, Pantic I, Stefanovic T, Kovacevic G et al. Relationship between mid-trimester ultrasound fetal liver length measurements and gestational diabetes mellitus. J Diabetes 2015; 7 (4): 497–505.

    Article  CAS  Google Scholar 

  4. Gojnic M, Stefanovic T, Perovic M, Arsic B, Garalejic E, Micic J et al. Prediction of fetal macrosomia with ultrasound parameters and maternal glycemic controls in gestational diabetes mellitus. Clin Exp Obstet Gynecol 2012; 39 (4): 512–515.

    CAS  PubMed  Google Scholar 

  5. Anderson NG, Notley E, Graham P, McEwing R . Reproducibility of sonographic assessment of fetal liver length in diabetic pregnancies. Ultrasound Obstet Gynecol 2008; 31 (5): 529–534.

    Article  CAS  Google Scholar 

  6. Chang FM, Hsu KF, Ko HC, Yao BL, Chang CH, Yu CH et al. Three-dimensional ultrasound assessment of fetal liver volume in normal pregnancy: a comparison of reproducibility with two-dimensional ultrasound and a search for a volume constant. Ultrasound Med Biol 1997; 23 (3): 381–389.

    Article  CAS  Google Scholar 

  7. Dos Santos Rizzi MC, Araujo Júnior E, Nardozza LM, Diniz AL, Rolo LC, Moron AF . Nomogram of fetal liver volume by three-dimensional ultrasonography at 27 to 38 weeks of pregnancy using a new multiplanar technique. Am J Perinatol 2010; 27 (8): 641–648.

    Article  Google Scholar 

  8. Dubé MC, Girard M, Morisset AS, Tchernof A, Weisnagel SJ, Bujold E . Evaluation of fetal liver volume by tridimensional ultrasound in women with gestational diabetes mellitus. J Obstet Gynaecol Can 2011; 33 (11): 1095–1098.

    Article  Google Scholar 

  9. Boito SM, Struijk PC, Ursem NT, Stijnen T, Wladimiroff JW . Assessment of fetal liver volume and umbilical venous volume flow in pregnancies complicated by insulin-dependent diabetes mellitus. BJOG 2003; 110 (11): 1007–1013.

    Article  Google Scholar 

  10. Garcia-Flores J, Cruceyra M, Cañamares M, Garicano A, Nieto O, Lopez A et al. Fetal limb soft tissue assessment for prediction of birth weight and umbilical cord blood analytes in gestational diabetes. Prenat Diagn 2015; 35: 1187–1196.

    Article  CAS  Google Scholar 

  11. Fonseca MJ, Santos AC . Umbilical cord blood adipokines and newborn weight change. Arch Gynecol Obstet 2014; 291: 1037–1040.

    Article  Google Scholar 

  12. Josefson JL, Zeiss DM, Rademaker AW, Metzger BE . Maternal leptin predicts adiposity of the neonate. Horm Res Paediatr 2014; 81 (1): 13–19.

    Article  CAS  Google Scholar 

  13. Jahan S, Zinnat R, Hassan Z, Biswas KB, Habib SH . Gender differences in serum leptin concentrations from umbilical cord blood of newborn infants born to nondiabetic, gestational diabetic and type-2 diabetic mothers. Int J Diabetes Dev Ctries 2009; 29 (4): 155–158.

    Article  Google Scholar 

  14. Dubé MC, Morisset AS, Tchernof A, Weisnagel SJ . Cord blood C-peptide levels relate to the metabolic profile of women with and without gestational diabetes. Acta Obstet Gynecol Scand 2012; 91 (12): 1469–1473.

    Article  Google Scholar 

  15. Teramo KA, Widness JA . Increased fetal plasma and amniotic fluid erythropoietin concentrations: markers of intrauterine hypoxia. Neonatology 2009; 95 (2): 105–116.

    Article  CAS  Google Scholar 

  16. Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. National Diabetes Data Group. Diabetes 1979; 28: 1039–1057.

  17. Spanish Society of Gynecology and Obstetrics (Perinatal Medicine Section) Spanish Tables for Neonatal Weight by Gestational Age. Laboratorios Menarini: Madrid, Spain, 1998.

  18. Snijders RJ, Nicolaides KH . Fetal biometry at 14-40 weeks' gestation. Ultrasound Obstet Gynecol 1994; 4 (1): 34–48.

    Article  CAS  Google Scholar 

  19. Szpinda M, Paruszewska-Achtel M, Woźniak A, Badura M, Mila-Kierzenkowska C, Wiśniewski M . Three-dimensional growth dynamics of the liver in the human fetus. Surg Radiol Anat 2015; 37 (5): 439–448.

    Article  Google Scholar 

  20. Al-Badri MR, Zantout MS, Azar ST . The role of adipokines in gestational diabetes mellitus. Ther Adv Endocrinol Metab 2015; 6 (3): 103–108.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We gratefully acknowledge Israel J Thuissard for expert technical assistance. We thank Cristina Criado, Maria Caballero and all the nursing staff on the Labor and Delivery Unit, who were responsible for the management of the umbilical cord sample for the present study. We also thank all the Obstetrics and Gynecology Department and Clinical Analysis Department staff for their helpful collaboration. This study was funded by grants by Fundación Mutua Madrileña (grant number AP105302012) and Fundación Universidad Europea de Madrid (grant number 2013/UEM22). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author information

Authors and Affiliations

  1. Obstetrics and Gynecology Department, High-Risk Pregnancy and Prenatal Diagnosis Unit, Hospital Universitario Quiron Madrid, Pozuelo de Alarcon, Madrid, Spain

    J Garcia-Flores, M Cruceyra, M Cañamares, A Garicano, O Nieto & I Tamarit

Authors
  1. J Garcia-Flores
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M Cruceyra
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M Cañamares
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A Garicano
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. O Nieto
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. I Tamarit
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J Garcia-Flores.

Ethics declarations

Competing interests

The authors declare no other conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Garcia-Flores, J., Cruceyra, M., Cañamares, M. et al. Predictive value of fetal hepatic biometry for birth weight and cord blood markers in gestational diabetes. J Perinatol 36, 723–728 (2016). https://doi.org/10.1038/jp.2016.72

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2016.72

Search

Advanced search

Quick links