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Risk factors and glycaemic control in small-for-gestational-age infants born to mothers with gestational diabetes

Jianing Li1,2, Yuqing Pan2, Qingxiang Zheng2

  • 1Fujian Medical University School of Nursing, Fuzhou, Fujian, China.

BMJ Open
|January 10, 2024
PubMed

Insights

Pregnancy risk factors and glycaemic control impact small for gestational age (SGA) infants born to mothers with gestational diabetes mellitus (GDM). Identifying these factors is crucial for reducing SGA risks and improving neonatal outcomes.

Area of Science:

  • Perinatal Medicine
  • Endocrinology
  • Neonatology

Background:

  • Small for gestational age (SGA) infants face increased neonatal complications and adult metabolic disorders.
  • Maternal gestational diabetes mellitus (GDM) further elevates risks for both mother and infant.
  • Specific pregnancy risk factors and glycaemic control nuances for SGA in GDM pregnancies are not well understood.

Purpose of the Study:

  • To determine pregnancy risk factors associated with SGA infants born to mothers with GDM.
  • To investigate the role of glycaemic control in the development of SGA in GDM pregnancies.

Main Methods:

  • A case-control study involving 1910 women with GDM in China.
  • Propensity score matching (1:4 ratio) was used to control for gestational age.
  • Univariate and multivariate analyses identified significant risk and protective factors.

Main Results:

  • Identified risk factors for SGA included maternal history of low birth weight, gestational hypertension, oligohydramnios, short stature, underweight pre-pregnancy BMI, and inadequate weight gain.
  • Protective factors against SGA were weakly positive first-trimester ketonuria, multiparity, anemia, and previous uterine scarring.
  • Second-trimester 2-hour postprandial glucose, HbA1c, and oral glucose tolerance test (OGTT) results were linked to SGA risk.

Conclusions:

  • SGA in GDM pregnancies results from complex interactions between maternal factors and glycaemic control.
  • Glycaemic control during pregnancy is significantly associated with SGA development.
  • Enhanced perinatal monitoring and antenatal care are recommended to mitigate SGA risks in GDM pregnancies.
Abstract

Keywords:
Child protectionDiabetes in pregnancyRisk Factors

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