WOMENS-HEALTH Messages for January, 2001: Gestational diabetes/macrosomia ?

Gestational diabetes/macrosomia ?

From: MEG (anonymous@obgyn.net)
Wed, 3 Jan 2001 23:00:48 -0600 (CST)

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My 4th gestational diabetic pregnancy just ended with the delivery of an 11lb baby girl with a 15in head. My BSL were perfect through out the pregnancy and I did not need to go on insulin. As a whole, my BSL dropped dramatically in the last few weeks of the pregnancy and my hemmoglobin A1c was 5.0 3 weeks before she was born. Though I had been measuring as much as 8cm ahead earlier in the pregnancy and an U/S at 35wks estimated the baby to be about 8lbs, we were not expecting such a large baby. By the time she was born I was only measuring 2cm large for dates.

the other weights/head measurements of my other children are as follows: #1 37wks 9lbs 3oz, 15in head #2 39wks 8lbs 3oz 13in head insulin dependant #3 40wks 9lbs 9oz 13.5in head insulin dependant. #4 41wks 11lbs 15in head

The 2 that I had the most trouble controling blood sugars with and had to go on insulin with were considerably smaller(and the one that I had the most trouble with and took the highest doses of insulin with was my smallest). there was no indication at all that I needed insulin in the first and last pregnancies.

My question is why were those 2 babies so big? I know you cannot give me a flat answer, but I am curious about any theories you may have. My own OB said she didn't really know, but that there was a theory that insulin resistance can interfere with a growth factor. She didn't have a chance to elaborate and I can't find any info on this online.

I wonder if in future pregnancies if I should take a prophylactic dose of insulin, regardless of my blood sugars? Or are these babies just gentically larger than the other 2?

I would appreciate any insights.

--
Meg

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