Relative importance of maternal constitutional factors and glucose intolerance of pregnancy in the development of newborn macrosomia

An abnormal screening glucose challenge test in pregnancy predicts postpartum metabolic dysfunction, even when the antepartum oral glucose tolerance test is normal

“…In some cases, abnormal GCT with NGT has been associated with adverse perinatal outcomes and LGA. [23][24][25] Moreover, consistent with these findings, Bevier et al showed that dietary counselling with a euglycaemic diet (consisting of 40% carbohydrate, 20% protein and 40% fat) and home glucose monitoring of fasting and postprandial glucose levels can reduce infant birthweight and Caesarean-section rates in this patient population. 26 By contrast, other investigators have not found evidence of foetal macrosomia or adverse perinatal outcomes in women with an abnormal GCT followed by NGT, 27,28 rendering the obstetrical implications of this presentation somewhat uncertain.…”

Perinatal and childhood risk factors for overweight in a provincial sample of Canadian Grade 5 students

“…The most likely explanation for the association between maternal weight and overweight in the offspring is that the hormonal milieu in utero creates an environment that leads to macrosomia and hyperinsulinism in the fetus, which in turn would favor the later development of overweight. The role of the prenatal environment is further highlighted by the observation that the associations of parental weight with macrosomia or a child's later overweight are stronger for the mother than for the father (47,48). Irrespective of the mechanism, the association of maternal obesity with a child's susceptibility for obesity is alarming as it represents an accumulation of risk for obesity for future generations (49).…”

Nutrition and Pregnancy Outcome

“…Overweight and high weight gain during pregnancy are both strong determinants of LGA infants and are important contributors to the increase in prevalence of macrosomic newborns in the last 10 to 20 years. [50][51][52][53] Women with gestational diabetes, hyperinsulinemia, and even upper-normal values on glucose tolerance tests are also at increased risk of giving birth to macrosomic infants. 54 Gestational diabetes and reduced glucose tolerance seem to be predictors of large birth size independent of maternal weight or body mass index.…”