Effects of maternal weight variations and gestational diabetes mellitus on neonatal birth weight.

We evaluated the effects of gestational weight gain on neonatal birthweight women in whom gestational diabetes mellitus (GDM) was diagnosed after the 32nd week of gestation. The prevalence of macrosomia, the birthweight differences from 50th percentile value of a reference population, and the relationships among plasma glucose values during oral glucose tolerance test and neonatal birthweight were evaluated in 60 newborns from mothers with gestational diabetes mellitus divided according to pregravid body-mass index. Serving as controls were 132 newborns of mothers with normal glucose tolerance. The prevalence of macrosomia was higher in the GDM group; the neonatal birthweight difference above 50th percentile value was higher in newborns of mothers with GDM; and a strong relationship between maternal gestational weight gain and neonatal birth weight was present in all pregnant women. In conclusion, (1) the gestational weight gain is a good predictor of neonatal birth weight in all pregnant women; (2) GDM enhances the increase in neonatal size induced by excessive gestational weight gain alone, and (3) a weight gain of more than 9 kg makes the relative risk of macrosomia twofold higher in GDM than in control mothers.

Non-paroxysmal arterioventricular junctional tachycardia during postprandial hypoglycaemia in an obese non-diabetic patient.

We have observed the simultaneous occurrence of postprandial hypoglycaemia and a rare cardiac arrhythmia: non-paroxysmal arteriovenous junctional tachycardia (NPJT) in a patient with suspected coronary heart disease (CHD) submitted to oral glucose tolerance testing (OGTT). To our knowledge the association between hypoglycaemia and NPJT has not been previously described. The pathogenesis of NPJT might involve a myocellular Ca2+ overloading determined by a hypoglycaemia-induced catecholamine discharge in a transiently ischaemic myocardium.