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Relationships Between Exposure to Gestational Diabetes Treatment and Neonatal Anthropometry: Evidence from the Born
Gilberte Martine-Edith1, William Johnson1, Emily S Petherick2
1School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Loughborough, LE11 3TU, UK.
Insights
Gestational diabetes mellitus (GDM) treatment, including insulin and metformin, was linked to smaller birth size in offspring. However, metformin-exposed newborns showed similar anthropometric traits to those exposed to insulin.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Health
- Endocrinology
Background:
- Gestational diabetes mellitus (GDM) affects maternal and neonatal health.
- Understanding the impact of GDM treatment on neonatal anthropometry is crucial for clinical practice.
Purpose of the Study:
- To investigate the association between different gestational diabetes mellitus (GDM) treatments and various neonatal anthropometric measurements.
- To compare the effects of lifestyle changes, insulin, and metformin on offspring birth characteristics.
Main Methods:
- A cohort study of 9907 offspring from the Born in Bradford cohort.
- Multivariable linear regression analyses were employed, adjusting for relevant covariates.
- GDM treatment type served as the exposure, with offspring of mothers without GDM as the control group.
Main Results:
- Offspring exposed to GDM treatment (insulin or metformin) exhibited lower birth weight compared to the control group, partly due to shorter gestational age and maternal ethnicity.
- Higher maternal glucose levels at diagnosis were associated with increased subscapular skinfolds in exposed offspring.
- Fully adjusted analyses revealed that GDM-treated offspring had lower weight, smaller abdominal circumference, and reduced skinfold thickness at birth.
Conclusions:
- Neonatal anthropometry is significantly influenced by gestational diabetes mellitus (GDM) treatment, with exposed infants being smaller at birth.
- Metformin exposure during pregnancy resulted in comparable birth anthropometric characteristics to insulin exposure, suggesting similar impacts on neonatal size.
Objectives:
To examine the relationships between gestational diabetes mellitus (GDM) treatment and neonatal anthropometry.
Methods:
Covariate-adjusted multivariable linear regression analyses were used in 9907 offspring of the Born in Bradford cohort. GDM treatment type (lifestyle changes advice only, lifestyle changes and insulin or lifestyle changes and metformin) was the exposure, offspring born to mothers without GDM the control, and birth weight, head, mid-arm and abdominal circumference, and subscapular and triceps skinfold thickness the outcomes.
Results:
Lower birth weight in offspring exposed to insulin (- 117.2 g (95% CI - 173.8, - 60.7)) and metformin (- 200.3 g (- 328.5, - 72.1)) compared to offspring not exposed to GDM was partly attributed to lower gestational age at birth and greater proportion of Pakistani mothers in the treatment groups. Higher subscapular skinfolds in offspring exposed to treatment compared to those not exposed to GDM was partly attributed to higher maternal glucose concentrations at diagnosis. In fully adjusted analyses, offspring exposed to GDM treatment had lower weight, smaller abdominal circumference and skinfolds at birth than those not exposed to GDM. Metformin exposure was associated with smaller offspring mid-arm circumference (- 0.3 cm (- 0.6, - 0.07)) than insulin exposure in fully adjusted models with no other differences found.
Conclusions For Practice:
Offspring exposed to GDM treatment were lighter and smaller at birth than those not exposed to GDM. Metformin-exposed offspring had largely comparable birth anthropometric characteristics to those exposed to insulin.
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