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Growth patterns among late preterm infants of mothers with diabetes
Catherine O Buck1, Veronika Shabanova1, Sarah N Taylor1
1Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA.
Insights
Infants born prematurely to mothers with diabetes had higher birth weights and experienced accelerated weight gain in the first week of life. These growth differences persisted to age two, indicating a need for further research into long-term risks.
Area of Science:
- Neonatal and Developmental Pediatrics
- Maternal-Fetal Medicine
- Pediatric Endocrinology
Background:
- Maternal diabetes mellitus (DM) is a known risk factor for offspring obesity and cardiometabolic diseases.
- Limited data exist on the growth patterns of preterm infants exposed to maternal diabetes during gestation.
Purpose of the Study:
- To compare early childhood growth trajectories between late preterm infants born to mothers with and without diabetes during pregnancy.
Main Methods:
- A retrospective longitudinal analysis compared weight trajectories from birth to 2 years.
- Mixed-effects modeling was used, adjusting for maternal and infant demographic covariates.
- The study included 1554 late preterm infants, with 134 exposed to maternal diabetes.
Main Results:
- Infants exposed to maternal diabetes (DM-group) had higher average birth weight (300g difference) and weight z-scores (0.67 SDS difference).
- DM-group infants exhibited accelerated weight gain from birth to discharge and in the first postnatal week.
- Higher average weight and weight z-scores were maintained through age two, with increased weight gain between 18 and 24 months.
Conclusions:
- Late preterm infants exposed to maternal diabetes demonstrate increased weight from birth to age two and accelerated early postnatal growth.
- Further investigation is warranted to understand the long-term health implications of these altered weight trajectories.
Objective:
Exposure to diabetes mellitus during pregnancy increases the risk of offspring obesity and cardiometabolic disease. Limited information exists regarding growth patterns among preterm infants exposed to maternal diabetes. This study describes growth differences during early childhood among late preterm infants of mothers with and without diabetes during pregnancy.
Materials And Methods:
In a retrospective longitudinal analysis, weight trajectories from birth to age 2 years were compared between diabetes exposure groups (N = 1554) using mixed effects modeling and adjusting for maternal and infant demographic covariates.
Results:
Overall, 134 (9%) infants were exposed to diabetes (DM-group). DM-group had higher average weight (adjusted difference 300 g [95% CI: 228, 371]) and weight z-score (adjusted difference 0.67 standard deviation scores (SDS) [95% CI: 0.50, 0.84]) compared with unexposed infants. DM-group infants had accelerated weight gain from birth to discharge (adjusted weight difference 31.8 g [95% CI: 12.5, 51.1], adjusted weight z-score difference 0.07 SDS [95% CI: 0.02, 0.11]) compared with unexposed infants, including in the first postnatal week (adjusted weight gain velocity difference, day 0-3: 6.07 g/day [95% CI: 0.88, 11.25]; day 3-7: 8.37 g/day [95% CI: 1.60, 15.13]). Through age two, infants in the DM-group maintained higher average weight (adjusted difference 185.7 g [95% CI: 37.2, 334.3]) and weight z-score (adjusted difference 0.32 SDS [95% CI: 0.09, 0.55]) than unexposed infants, with greater weight gain between 18 and 24 months (adjusted difference 28.5 g/week [95% CI: 2.6, 54.4]).
Conclusions:
Maternal diabetes exposed late preterm infants had higher weight from birth to age two and greater weight gain in the first postnatal week than unexposed infants. Long term risk associated with weight trajectories in this population requires further study.
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