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Birth size distribution in 3,705 infants born to mothers with type 1 diabetes: a population-based study

Martina Persson1, Dharmintra Pasupathy, Ulf Hanson

  • 1Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden. martina.persson@ki.se

Diabetes Care
|March 25, 2011
PubMed

Insights

Infants born to mothers with type 1 diabetes exhibit a broader and larger birth weight distribution, leading to increased fetal macrosomia. This suggests underlying metabolic issues, particularly in preterm and female infants.

Area of Science:

  • Reproductive Endocrinology
  • Pediatric Endocrinology
  • Perinatal Epidemiology

Background:

  • Fetal macrosomia is a common complication in pregnancies affected by type 1 diabetes.
  • Understanding birth size distribution, including birth weight (BW) and length (BL), is crucial for identifying causal pathways of macrosomia.
  • The ponderal index (PI) provides insights into fetal body composition and fat distribution.

Purpose of the Study:

  • To characterize the birth size distribution in infants born to mothers with type 1 diabetes.
  • To investigate the relationship between birth weight and length in this population.
  • To identify factors contributing to fetal macrosomia in diabetic pregnancies.

Main Methods:

  • Population-based cohort study of 3,705 infants born to mothers with type 1 diabetes in Sweden (1998-2007).
  • Birth weight and length data retrieved from the Medical Birth Registry, expressed as SD scores (SDS).
  • Proportionate and disproportionate large-for-gestational age (LGA) defined using BW and PI percentiles.

Main Results:

  • Birth weight distribution was significantly broader and shifted towards higher values in infants of mothers with type 1 diabetes (BWSDS: 1.27).
  • 47% of infants were LGA, with 46% of these being disproportionately large, compared to 35% in non-diabetic LGA infants.
  • Female and preterm infants of mothers with type 1 diabetes showed significantly higher birth weight SDS.

Conclusions:

  • Fetal macrosomia in type 1 diabetic pregnancies is characterized by a right-shifted and broadened birth weight distribution.
  • A high proportion of disproportionately large infants suggests an underlying metabolic dysregulation.
  • Preterm birth and female sex are associated with more pronounced fetal macrosomia in type 1 diabetic pregnancies.
Abstract

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