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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

Ed. by Bancalari, Eduardo / Chappelle, Joseph / Chervenak, Frank A. / D'Addario , Vincenzo / Genc, Mehmet R. / Greenough, Anne / Grunebaum, Amos / Kurjak M.D., Asim / Romero, Roberto / Zalud, MD PhD, Ivica

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Volume 43, Issue 3


Incorporating first trimester analytes to predict delivery of a large for gestational infant in women with impaired glucose tolerance

Rinat Gabbay-Benziv
  • Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Sertac Esin
  • Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Ahmet A. Baschat
  • Corresponding author
  • Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2014-05-01 | DOI: https://doi.org/10.1515/jpm-2014-0041


Aim: To investigate first trimester maternal characteristics of women with impaired glucose tolerance that deliver large for gestational age (LGA) infants.

Methods: Nested analysis from a prospective study of singleton pregnancies enrolled at first trimester. We studied women with an abnormal 1 h glucose challenge test that had normal follow-up oral glucose tolerance testing. Maternal characteristics, ultrasound parameters and serum analytes were stratified by subsequent delivery of an LGA infant. Parameters identified as significant on univariate analysis were used for a derivation of prediction by logistic regression. Odds ratio and prediction performance was determined using receiver operator curve (ROC) statistics.

Results: A total of 33/114 (28.9%) women meeting the criteria delivered LGA infants. Maternal height (cm), and first trimester pregnancy-associated protein-A and free β-hCG (MoM) predicted delivery of an LGA infant (ROC area under curve 0.73; 95% CI 0.63–0.83). At a cutoff value of 0.172 the prediction rule achieved 91% sensitivity, 44% specificity, 41% positive predictive and 92% negative predictive value.

Conclusion: Maternal height and first trimester high free β-hCG and PAPP-A levels may be used as predictors for delivery of LGA infants in women with impaired glucose tolerance.

Keywords: Abnormal glucose challenge test; gestational diabetes; impaired glucose tolerance large for gestational age


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About the article

Corresponding author: Dr. Ahmet A. Baschat, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA, E-mail:

Received: 2014-02-04

Accepted: 2014-04-04

Published Online: 2014-05-01

Published in Print: 2015-05-01

Citation Information: Journal of Perinatal Medicine, Volume 43, Issue 3, Pages 299–303, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/jpm-2014-0041.

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