{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T11:26:26Z","timestamp":1775733986037,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,4,20]],"date-time":"2022-04-20T00:00:00Z","timestamp":1650412800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Ultrasound assessment of fetuses subjected to hyperglycemia is recommended but, apart from increased size, little is known about its interpretation, and the identification of which large fetuses of diabetic pregnancy are at risk is unclear. Newer markers of adverse outcomes, abdominal circumference growth velocity and cerebro\u2010placental ratio, help to predict risk in non\u2010diabetic pregnancy. Our study aims to assess their role in pregnancies complicated by diabetes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>This is a retrospective analysis of a cohort of singleton, non\u2010anomalous fetuses of women with pre\u2010existing or gestational diabetes mellitus, and estimated fetal weight at the 10th centile or above. Gestational diabetes was diagnosed by selective screening of at risk groups. A universal ultrasound scan was offered at 20 and 36\u2009weeks of gestation. Estimated fetal weight, abdominal circumference growth velocity, presence of polyhydramnios, and cerebro\u2010placental ratio were evaluated at the 36\u2010week scan. A composite adverse outcome was defined as the presence of one or more of perinatal death, arterial cord pH less than 7.1, admission to Neonatal Unit, 5\u2010minute Apgar less than 7, severe hypoglycemia, or cesarean section for fetal compromise. A chi\u2010squared test was used to test the association of estimated fetal weight at the 90th centile or above, polyhydramnios, abdominal circumference growth velocity at the 90th centile or above, and cerebro\u2010placental ratio at the 5th centile or below with the composite outcome. Logistic regression was used to assess which ultrasound markers were independent risk factors. Odds ratios of composite adverse outcome with combinations of independent ultrasound markers were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1044 pregnancies were included, comprising 87 women with pre\u2010existing diabetes mellitus and 957 with gestational diabetes. Estimated fetal weight at the 90th centile or above, abdominal circumference growth velocity at the 90th centile or above, cerebro\u2010placental ratio at the 5th centile or below, but not polyhydramnios, were significantly associated with adverse outcomes: odds ratios (95% confidence intervals) 1.85 (1.21\u20132.84), 1.54 (1.02\u20132.31), 1.92 (1.21\u20133.30), and 1.53 (0.79\u20132.99), respectively. Only estimated fetal weight at the 90th centile or above and cerebro\u2010placental ratio at the 5th centile or below were independent risk factors. The greatest risk (odds ratio 6.85, 95% confidence interval 2.06\u201322.78) was found where both the estimated fetal weight is at the 90th centile or above and the cerebro\u2010placental ratio is at the 5th centile or below.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In diabetic pregnancies, a low cerebro\u2010placental ratio, particularly in a macrosomic fetus, confers additional risk.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14361","type":"journal-article","created":{"date-parts":[[2022,4,20]],"date-time":"2022-04-20T10:17:42Z","timestamp":1650449862000},"page":"787-793","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Ultrasound predictors of adverse outcome in pregnancy complicated by pre\u2010existing and gestational diabetes"],"prefix":"10.1111","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4781-9473","authenticated-orcid":false,"given":"Marta","family":"Garbagnati","sequence":"first","affiliation":[{"name":"Fetal Medicine Unit, Women's Centre, John Radcliffe Hospital  Oxford UK"},{"name":"Nuffield Department of Women's Reproductive Health, John Radcliffe Hospital Oxford University  Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6260-6740","authenticated-orcid":false,"given":"Christina Y. L.","family":"Aye","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Women's Centre, John Radcliffe Hospital  Oxford UK"},{"name":"Nuffield Department of Women's Reproductive Health, John Radcliffe Hospital Oxford University  Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2539-2648","authenticated-orcid":false,"given":"Angelo","family":"Cavallaro","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Women's Centre, John Radcliffe Hospital  Oxford UK"},{"name":"Nuffield Department of Women's Reproductive Health, John Radcliffe Hospital Oxford University  Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1609-3654","authenticated-orcid":false,"given":"Sam","family":"Mathewlynn","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Women's Centre, John Radcliffe Hospital  Oxford 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