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Intergenerational transmission of macrosomia in women with gestational diabetes and normal glucose tolerance.

Abstract

OBJECTIVES

It has been suggested that neonatal macrosomia may contribute to increased risk of obesity and type 2 diabetes in later life. Much less is known about the association between maternal birth weight (MBW) and offspring birth weight (OBW). This retrospective study evaluated the prevalence of macrosomia in women with treated gestational diabetes mellitus (GDM) and normal glucose tolerance during pregnancy. The study also investigated associations between MBW and OBW.

STUDY DESIGN

Medical records of 519 pregnant women with treated GDM and 766 women with normal glucose tolerance, referred to the Gestational Diabetes Outpatient Clinic in Szczecin, Poland, were analyzed. The following data were assessed: maternal age, pregravid body weight, height, gestational weight gain, prior GDM, prior macrosomia, MBW and OBW. Birth weight was classified as small for gestational age (SGA), appropriate for gestational age (AGA), large for gestational age (LGA) and macrosomia (≥4000g). OBW was obtained from birth certificates, and MBW was obtained from birth certificates or self-report.

RESULTS

The overall prevalence of macrosomia was 8.1%, and was comparable in subgroups of women with and without GDM (7.7% and 8.4%, respectively; p=0.905). The frequencies of SGA, AGA and LGA did not differ between study groups. A positive correlation was found between MBW and OBW in women with treated GDM (r=0.211, p<0.001) and in women with normal glucose tolerance (r=0.220, p<0.001). Regardless of glucose tolerance status during pregnancy, the greatest proportion of macrosomic babies were born to mothers who were themselves born macrosomic (26.5% in mothers with GDM and 20.0% in mothers with normal glucose tolerance; p=0.631). On logistic regression, MBW was found to be a robust predictor of macrosomia in offspring [odds ratio (OR) 1.64, 95% confidence interval (CI) 1.15-2.36 in women with treated GDM; OR 1.35, 95% CI 1.07-1.76 in women with normal glucose tolerance). Other independent predictors of fetal macrosomia were gestational weight gain, prior macrosomia and pregravid body mass index (BMI).

CONCLUSIONS

MBW, prior macrosomia, pregravid BMI and gestational weight gain were predictors of macrosomia in offspring, but GDM was not. High MBW seems to contribute to intergenerational transmission of macrosomia.

Authors+Show Affiliations

Outpatient Clinic for Diabetic Pregnant Women, Provincial Hospital, Szczecin, Poland; Department of Civilization Diseases, Pomeranian Medical University, Szczecin, Poland.Department of Hypertension and Internal Medicine, Pomeranian Medical University, Szczecin, Poland. Electronic address: miazgowski@interia.pl.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26512436

Citation

Ogonowski, J, and T Miazgowski. "Intergenerational Transmission of Macrosomia in Women With Gestational Diabetes and Normal Glucose Tolerance." European Journal of Obstetrics, Gynecology, and Reproductive Biology, vol. 195, 2015, pp. 113-6.
Ogonowski J, Miazgowski T. Intergenerational transmission of macrosomia in women with gestational diabetes and normal glucose tolerance. Eur J Obstet Gynecol Reprod Biol. 2015;195:113-6.
Ogonowski, J., & Miazgowski, T. (2015). Intergenerational transmission of macrosomia in women with gestational diabetes and normal glucose tolerance. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 195, pp. 113-6. doi:10.1016/j.ejogrb.2015.10.002.
Ogonowski J, Miazgowski T. Intergenerational Transmission of Macrosomia in Women With Gestational Diabetes and Normal Glucose Tolerance. Eur J Obstet Gynecol Reprod Biol. 2015;195:113-6. PubMed PMID: 26512436.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intergenerational transmission of macrosomia in women with gestational diabetes and normal glucose tolerance. AU - Ogonowski,J, AU - Miazgowski,T, Y1 - 2015/10/20/ PY - 2015/03/30/received PY - 2015/08/04/revised PY - 2015/10/06/accepted PY - 2015/10/30/entrez PY - 2015/10/30/pubmed PY - 2016/9/27/medline KW - Birth weight KW - Gestational diabetes KW - Macrosomia SP - 113 EP - 6 JF - European journal of obstetrics, gynecology, and reproductive biology JO - Eur. J. Obstet. Gynecol. Reprod. Biol. VL - 195 N2 - OBJECTIVES: It has been suggested that neonatal macrosomia may contribute to increased risk of obesity and type 2 diabetes in later life. Much less is known about the association between maternal birth weight (MBW) and offspring birth weight (OBW). This retrospective study evaluated the prevalence of macrosomia in women with treated gestational diabetes mellitus (GDM) and normal glucose tolerance during pregnancy. The study also investigated associations between MBW and OBW. STUDY DESIGN: Medical records of 519 pregnant women with treated GDM and 766 women with normal glucose tolerance, referred to the Gestational Diabetes Outpatient Clinic in Szczecin, Poland, were analyzed. The following data were assessed: maternal age, pregravid body weight, height, gestational weight gain, prior GDM, prior macrosomia, MBW and OBW. Birth weight was classified as small for gestational age (SGA), appropriate for gestational age (AGA), large for gestational age (LGA) and macrosomia (≥4000g). OBW was obtained from birth certificates, and MBW was obtained from birth certificates or self-report. RESULTS: The overall prevalence of macrosomia was 8.1%, and was comparable in subgroups of women with and without GDM (7.7% and 8.4%, respectively; p=0.905). The frequencies of SGA, AGA and LGA did not differ between study groups. A positive correlation was found between MBW and OBW in women with treated GDM (r=0.211, p<0.001) and in women with normal glucose tolerance (r=0.220, p<0.001). Regardless of glucose tolerance status during pregnancy, the greatest proportion of macrosomic babies were born to mothers who were themselves born macrosomic (26.5% in mothers with GDM and 20.0% in mothers with normal glucose tolerance; p=0.631). On logistic regression, MBW was found to be a robust predictor of macrosomia in offspring [odds ratio (OR) 1.64, 95% confidence interval (CI) 1.15-2.36 in women with treated GDM; OR 1.35, 95% CI 1.07-1.76 in women with normal glucose tolerance). Other independent predictors of fetal macrosomia were gestational weight gain, prior macrosomia and pregravid body mass index (BMI). CONCLUSIONS: MBW, prior macrosomia, pregravid BMI and gestational weight gain were predictors of macrosomia in offspring, but GDM was not. High MBW seems to contribute to intergenerational transmission of macrosomia. SN - 1872-7654 UR - https://www.unboundmedicine.com/medline/citation/26512436/Intergenerational_transmission_of_macrosomia_in_women_with_gestational_diabetes_and_normal_glucose_tolerance_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0301-2115(15)00353-X DB - PRIME DP - Unbound Medicine ER -