{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T15:52:28Z","timestamp":1792857148040,"version":"4.5.0"},"reference-count":21,"publisher":"American Diabetes Association","issue":"7","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2001,7,1]]},"abstract":"<jats:p>OBJECTIVE\u2014To examine the hypothesis that early second trimester amniotic fluid (AF) insulin concentration is elevated and later fetal growth is augmented in gravidas demonstrating later oral glucose intolerance.<\/jats:p>\n               <jats:p>RESEARCH DESIGN AND METHODS\u2014In this prospective observational cohort study, AF was sampled at 14\u201320 weeks\u2019 gestation in 247 subjects, and 1-h 50-g oral glucose challenge tests (GCTs) were performed at \u226524 weeks. AF insulin was assayed by an automated immuno-chemiluminometric assay (8). Macrosomia was defined as birth weight above the 90th centile.<\/jats:p>\n               <jats:p>RESULTS\u2014AF insulin concentration (range 1.4\u201344.5 pmol\/l) correlated positively with gestational age and maternal weight. A logistic regression analysis, adjusted for maternal age and midpregnancy weight, showed increased AF insulin multiples of gestational age-specific medians to be associated with subsequently diagnosed gestational diabetes mellitus (GDM) (OR 1.9, CI 1.3\u20132.4, P = 0.029). Among 60 subjects with GCT values &amp;gt;7.2 mmol\/l, each unit increase in AF insulin multiple of median (MOM) was associated with a threefold increase in fetal macrosomia incidence (3.1, 1.3\u20134.9, P = 0.048).<\/jats:p>\n               <jats:p>CONCLUSIONS\u2014An elevated AF insulin concentration at 14\u201320 weeks\u2019 gestation is associated with subsequently documented maternal glucose intolerance. Among gravidas with GCT values &amp;gt;7.2 mmol\/l, elevated early AF insulin concentration is associated with fetal macrosomia. Maternal glucose intolerance may affect fetal insulin production before 20 weeks\u2019 gestation.<\/jats:p>","DOI":"10.2337\/diacare.24.7.1259","type":"journal-article","created":{"date-parts":[[2007,3,5]],"date-time":"2007-03-05T22:51:27Z","timestamp":1173135087000},"page":"1259-1263","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":73,"title":["Amniotic Fluid Insulin at 14\u201320 Weeks\u2019 Gestation"],"prefix":"10.2337","volume":"24","author":[{"given":"Marshall W.","family":"Carpenter","sequence":"first","affiliation":[{"name":"Obstetrics and Gynecology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob A.","family":"Canick","sequence":"additional","affiliation":[{"name":"Pathology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph W.","family":"Hogan","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology and"},{"name":"Center for Statistical Sciences, Brown University School of Medicine, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Curtis","family":"Shellum","sequence":"additional","affiliation":[{"name":"Beckman Instruments, Chaska, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Somers","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jami A.","family":"Star","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","reference":[{"key":"2022031215485610800_R1","doi-asserted-by":"crossref","unstructured":"Reiher H, Fuhrmann K, Noack S, Woltanski KP, Jutzi E, Hahn von Dorsche H, Hahn HJ: Age-dependent insulin secretion of the endocrine pancreas in vitro from fetuses of diabetic and nondiabetic patients. 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