Gestational diabetes and offspring body disproportion

Area of Science:

• Reproductive Endocrinology
• Neonatal Health
• Maternal-Fetal Medicine

Background:

• Infants born large for gestational age (LGA) with increased weight but not length are at higher risk of adult obesity.
• Gestational diabetes mellitus (GDM) is a common pregnancy complication with potential long-term health implications for both mother and child.

Purpose of the Study:

• To investigate whether women with GDM are at increased risk of delivering infants who are large for gestational age (LGA) and disproportionately heavy for their length.
• To explore the association between GDM and the specific phenotype of LGA infants characterized by excessive weight relative to length.

Main Methods:

• Analysis of birth characteristics from a large cohort including 884,267 infants of non-diabetic mothers and 7,817 infants of mothers with GDM.
• Definition of LGA based on birth weight or length exceeding 2 standard deviation scores for gestational age.
• Application of multiple logistic regression to assess risk factors and odds ratios.

Main Results:

• Women with GDM had a nearly fourfold increased odds ratio (3.71) of delivering an LGA infant that was heavy alone (disproportionately heavy for length).
• Among LGA infants, those born to mothers with GDM showed a higher proportion (68%) that were heavy alone compared to non-diabetic mothers (64.4%).
• The observed increased risk was independent of the fetus's gender.

Conclusions:

• Gestational diabetes mellitus is associated with a significantly elevated risk of delivering LGA infants with a disproportionate weight-to-length ratio.
• This specific pattern of fetal growth in infants born to mothers with GDM may contribute to an increased risk of obesity later in life.