Risk of fetal undergrowth in the management of gestational diabetes mellitus in Japan
Maki Kawasaki1,2, Naoko Arata2, Takashi Sugiyama3
1Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan.
Insights
A new registry system in Japan identified that gestational diabetes mellitus (GDM) significantly increases the risk of low birth weight (LBW). Managing maternal weight gain may reduce fetal growth issues in non-overweight women with GDM.
Area of Science:
- Reproductive Health
- Endocrinology
- Perinatal Medicine
Background:
- Rising rates of underweight women of reproductive age in Japan are linked to increased low birth weight (LBW) incidence.
- Gestational diabetes mellitus (GDM) poses significant risks to maternal and infant health.
- Standardized diagnostic criteria for GDM are crucial for accurate assessment and management.
Purpose of the Study:
- To establish a prospective registry for gestational diabetes mellitus (GDM) in Japan.
- To determine the prevalence and characteristics of GDM using the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria.
- To investigate the association between GDM and adverse pregnancy outcomes, including LBW.
Main Methods:
- Prospective enrollment of pregnant women diagnosed with GDM and a normal glucose tolerance (NGT) group.
- Standardized 75g oral glucose tolerance testing for glucose screening positive participants by gestational week 32.
- Data collection on GDM management, maternal, and neonatal outcomes.
Main Results:
- Analysis of 1,795 singleton pregnancies (878 GDM, 824 NGT).
- Significantly higher risk of LBW and small-for-gestational age in the GDM group compared to the NGT group.
- LBW risk associated with GDM was observed in non-overweight/obese women, but not in overweight/obese women.
Conclusions:
- A prospective GDM registry system was successfully established in Japan.
- Maternal weight gain suppression in GDM management may reduce fetal growth, particularly in non-overweight/obese individuals.
- Further research is needed to confirm the impact of weight management strategies on fetal growth in GDM pregnancies.
Aims/Introduction:
In Japan, the increasing frequency of underweight among women of reproductive age and the accompanying increase in the rate of low birth weight (LBW) are social issues. The study aimed to establish a prospective registry system for gestational diabetes mellitus (GDM) in Japan and to clarify the actual status of GDM according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria.
Materials And Methods:
Pregnant women with gestational diabetes mellitus and those in the normal glucose tolerance (NGT) group were enrolled in the Diabetes and Pregnancy Outcome for Mother and Baby study from October 2015. Pregnant women with positive glucose screening in early and mid-to-late pregnancy underwent a 75 g oral glucose tolerance test by gestational week 32. Gestational diabetes mellitus was diagnosed according to IADPSG criteria. Women with a positive glucose screening test at mid-to-late pregnancy but NGT were enrolled as references (NGT group). Treatment for gestational diabetes mellitus and maternal and neonatal pregnancy data were prospectively collected on outcomes.
Results:
In total 1,795 singleton pregnancies (878 women with GDM and 824 NGT women) were analyzed. The risk of LBW and small-for-gestational age in the GDM group was significantly higher than in the NGT group. A similar relationship was found for LBW risk in the non-overweight/obese group but not in the overweight/obese group.
Conclusions:
We established a prospective GDM registry system in Japan. In the management of GDM in Japan, suppression of maternal weight gain may be associated with reduced fetal growth, especially in non-overweight/obese women with GDM; however, further investigation is required.
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