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Ponderal Index Increases With Maternal Glucose, but Large for Gestational Age Better Predicts Infant Morbidity in

Jasmin Barikan1,2, Anna Hagman3, Linnea Bohlin3,4

  • 1University of Gothenburg at the Sahlgrenska Academy, Gothenburg, Sweden.

Acta Paediatrica (Oslo, Norway : 1992)
|October 15, 2025
PubMed

Insights

In type 1 diabetes pregnancies, higher maternal glucose increases the risk of delivering a large infant (high ponderal index). However, large for gestational age (LGA) remains a better predictor of infant morbidity than ponderal index.

Area of Science:

  • Obstetrics and Gynecology
  • Neonatology
  • Endocrinology

Background:

  • Large for gestational age (LGA) is a common but imperfect indicator of neonatal risk.
  • Infants born large for gestational age (LGA) are not always associated with adverse outcomes.
  • Ponderal index (PI) is an alternative measure of infant size.

Purpose of the Study:

  • To investigate the relationship between maternal glucose levels and ponderal index (PI) in pregnancies with type 1 diabetes.
  • To evaluate the predictive value of PI and LGA for infant morbidity in type 1 diabetes pregnancies.

Main Methods:

  • Secondary analysis of retrospective data from 118 women with type 1 diabetes (2014-2020).
  • Continuous glucose monitoring data and neonatal outcomes were analyzed.
  • Logistic regression was used to assess associations between glucose variables, PI, LGA, and infant morbidity.

Main Results:

  • Elevated first-trimester glycated hemoglobin and second/third-trimester glucose levels were associated with higher infant PI.
  • No significant association was found between PI and infant morbidity.
  • Large for gestational age (LGA) status was linked to a fourfold increase in infant morbidity risk and doubled risk of neonatal hypoglycemia.

Conclusions:

  • Maternal hyperglycemia in type 1 diabetes pregnancies correlates with increased infant ponderal index.
  • Large for gestational age (LGA) is a more reliable predictor of infant morbidity compared to ponderal index in this population.
Abstract

Keywords:
continuous glucose monitoringinfant morbiditylarge for gestational ageponderal indextype 1 diabetes

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