Relationship Between Gestational Diabetes Mellitus and Low Maternal Birth Weight

Abstract

OBJECTIVE -To study the relationship between low birth weight and the presence of gestational diabetes mellitus (GDM) or peripheral insulin resistance during pregnancy.RESEARCH DESIGN AND METHODS -We studied the relationship between peripheral insulin sensitivity (calculated by Matsuda and DeFronzo's oral glucose tolerance test (OGTT)-derived insulin sensitivity index [ISI OGTT ]) or GDM prevalence and birth weight in 604 pregnant women, classified as normally glucose tolerant (n ϭ 462) or affected with GDM (n ϭ 142) after a 100-g 3-h oral glucose tolerance test. We then categorized these subjects into two groups: individuals with birth weight in the Ͻ10th percentile (Ͻ2,600 g; n ϭ 68) and individuals with birth weight in the Ͼ10th percentile (n ϭ 536).RESULTS -GDM prevalence was higher in the group in the lowest birth weight decile (Ͻ2,600 g; 24/68; 35%) than in the group with normal/high birth weight (118/536; 22%; 2 ϭ 5.917; P ϭ 0.01). Relative risk for GDM adjusted for age, parity, family history of diabetes, and prepregnancy body weight was about twofold in the group with low birth weight (odds ratio ϭ 1.89 [95% CI 1.088 -3.285; P ϭ 0.023]), and the prevalence of low birth weight was about threefold higher in the first ISI OGTT decile. In 450 women whose newborn's weight was known, the delivery of macrosomic babies was associated with a twofold higher relative risk for GDM in women who themselves had low birth weight. In the latter, the relationships between their newborn's weight and either maternal glucose tolerance (positive) or ISI OGTT (negative) were amplified.CONCLUSIONS -Low maternal birth weight was associated with a twofold higher risk for GDM, independent of major confounders. Such a risk was highest in women with low birth weight who delivered macrosomic babies, and in the group with low birth weight, the relationship between maternal glucose tolerance or insulin resistance and offspring's neonatal weight was much more evident.

Prevalence and perinatal outcomes in GDM and non-GDM in a rural pregnancy cohort of Bangladesh

“…6 For Bangladesh, it seems important to determine the prevalence of GDM for several reasons. Firstly, Bangladeshi women showed higher prevalence of IGT than their male counterpart.…”

Non classical risk factors for gestational diabetes mellitus: a systematic review of the literature

“…In 2002, in Italy, Seghieri et al 22 found a significant association between birth weight < 2,600g and gestational diabetes mellitus after adjustment for age, parity, family history of diabetes mellitus and pre-pregnancy BMI. The odds ratio to present gestational diabetes mellitus was nearly two times higher among women with birth weight < 2,600g, when compared to higher birth weights (OR: 1.89; 95%CI: 1.09-3.29).…”

The intergenerational effects of fetal programming: non-genomic mechanisms for the inheritance of low birth weight and cardiovascular risk

“…However, the association between maternal diabetes, offspring birth weight and subsequent diabetes is complex because gestational diabetes predisposes to macrosomic infants with higher birth weight (Silverman et al 1991). Women of low birth weight are at increased risk of developing gestational diabetes and type 2 diabetes (Williams et al 1999, Egeland et al 2000, Forsen et al 2000, Innes et al 2002, Seghieri et al 2002 and hence deliver larger babies (Seghieri et al 2002). 'Macrosomic' offspring are themselves at risk of developing obesity (Pettitt et al 1993, Gillman et al 2003, gestational diabetes (Innes et al 2002) and type 2 diabetes later in life (Pettitt et al 1993, Lindsay et al 2000, Catalano et al 2003.…”