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Disproportionate body composition and neonatal outcome in offspring of mothers with and without gestational diabetes mellitus.

Abstract

OBJECTIVE

High birth weight is a risk factor for neonatal complications. It is not known if the risk differs with body proportionality. The primary aim of this study was to determine the risk of adverse pregnancy outcome in relation to body proportionality in large-for-gestational-age (LGA) infants stratified by maternal gestational diabetes mellitus (GDM).

RESEARCH DESIGN AND METHODS

Population-based study of all LGA (birth weight [BW] >90th percentile) infants born to women with GDM (n = 1,547) in 1998-2007. The reference group comprised LGA infants (n = 83,493) born to mothers without diabetes. Data were obtained from the Swedish Birth Registry. Infants were categorized as proportionate (P-LGA) if ponderal index (PI) (BW in grams/length in cm(3)) was ≤90th percentile and as disproportionate (D-LGA) if PI >90th percentile. The primary outcome was a composite morbidity: Apgar score 0-3 at 5 min, birth trauma, respiratory disorders, hypoglycemia, or hyperbilirubinemia. Logistic regression analysis was used to obtain odds ratios (ORs) for adverse outcomes.

RESULTS

The risk of composite neonatal morbidity was increased in GDM pregnancies versus control subjects but comparable between P- and D-LGA in both groups. D-LGA infants born to mothers without diabetes had significantly increased risk of birth trauma (OR 1.19 [95% CI 1.09-1.30]) and hypoglycemia (1.23 [1.11-1.37]). D-LGA infants in both groups had significantly increased odds of Cesarean section.

CONCLUSIONS

The risk of composite neonatal morbidity is significantly increased in GDM offspring. In pregnancies both with and without GDM, the risk of composite neonatal morbidity is comparable between P- and D-LGA.

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    Corresponding author: Martina Persson, martina.persson@ki.se.

    , ,

    Source

    Diabetes care 36:11 2013 Nov pg 3543-8

    MeSH

    Adult
    Birth Weight
    Body Composition
    Cesarean Section
    Cohort Studies
    Diabetes, Gestational
    Female
    Humans
    Hypoglycemia
    Infant
    Infant, Newborn
    Infant, Newborn, Diseases
    Male
    Mothers
    Odds Ratio
    Overweight
    Pregnancy
    Pregnancy Outcome
    Risk Factors

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    24159180

    Citation

    Persson, Martina, et al. "Disproportionate Body Composition and Neonatal Outcome in Offspring of Mothers With and Without Gestational Diabetes Mellitus." Diabetes Care, vol. 36, no. 11, 2013, pp. 3543-8.
    Persson M, Fadl H, Hanson U, et al. Disproportionate body composition and neonatal outcome in offspring of mothers with and without gestational diabetes mellitus. Diabetes Care. 2013;36(11):3543-8.
    Persson, M., Fadl, H., Hanson, U., & Pasupathy, D. (2013). Disproportionate body composition and neonatal outcome in offspring of mothers with and without gestational diabetes mellitus. Diabetes Care, 36(11), pp. 3543-8. doi:10.2337/dc13-0899.
    Persson M, et al. Disproportionate Body Composition and Neonatal Outcome in Offspring of Mothers With and Without Gestational Diabetes Mellitus. Diabetes Care. 2013;36(11):3543-8. PubMed PMID: 24159180.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Disproportionate body composition and neonatal outcome in offspring of mothers with and without gestational diabetes mellitus. AU - Persson,Martina, AU - Fadl,Helena, AU - Hanson,Ulf, AU - Pasupathy,Dharmintra, PY - 2013/10/26/entrez PY - 2013/10/26/pubmed PY - 2015/3/21/medline SP - 3543 EP - 8 JF - Diabetes care JO - Diabetes Care VL - 36 IS - 11 N2 - OBJECTIVE: High birth weight is a risk factor for neonatal complications. It is not known if the risk differs with body proportionality. The primary aim of this study was to determine the risk of adverse pregnancy outcome in relation to body proportionality in large-for-gestational-age (LGA) infants stratified by maternal gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS: Population-based study of all LGA (birth weight [BW] >90th percentile) infants born to women with GDM (n = 1,547) in 1998-2007. The reference group comprised LGA infants (n = 83,493) born to mothers without diabetes. Data were obtained from the Swedish Birth Registry. Infants were categorized as proportionate (P-LGA) if ponderal index (PI) (BW in grams/length in cm(3)) was ≤90th percentile and as disproportionate (D-LGA) if PI >90th percentile. The primary outcome was a composite morbidity: Apgar score 0-3 at 5 min, birth trauma, respiratory disorders, hypoglycemia, or hyperbilirubinemia. Logistic regression analysis was used to obtain odds ratios (ORs) for adverse outcomes. RESULTS: The risk of composite neonatal morbidity was increased in GDM pregnancies versus control subjects but comparable between P- and D-LGA in both groups. D-LGA infants born to mothers without diabetes had significantly increased risk of birth trauma (OR 1.19 [95% CI 1.09-1.30]) and hypoglycemia (1.23 [1.11-1.37]). D-LGA infants in both groups had significantly increased odds of Cesarean section. CONCLUSIONS: The risk of composite neonatal morbidity is significantly increased in GDM offspring. In pregnancies both with and without GDM, the risk of composite neonatal morbidity is comparable between P- and D-LGA. SN - 1935-5548 UR - https://www.unboundmedicine.com/medline/citation/24159180/full_citation L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&pmid=24159180 DB - PRIME DP - Unbound Medicine ER -