Relationship Between Gestational Diabetes Mellitus and Low Maternal Birth Weight

• Published in: Diabetes care Vol. 25; no. 10; pp. 1761 - 1765
• Main Authors: SEGHIERI, Giuseppe, ANICHINI, Roberto, DE BELLIS, Alessandra, ALVIGGI, Lorenzo, FRANCONI, Flavia, BRESCHI, Maria Cristina
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.10.2002
• Subjects: Adult; Analysis. Health state; Biological and medical sciences; Birth weight; Birth Weight - physiology; Birth weight, Low; Blood Pressure; Body Mass Index; Diabetes; Diabetes in pregnancy; Diabetes Mellitus - epidemiology; Diabetes Mellitus - genetics; Diabetes, Gestational - blood; Diabetes, Gestational - epidemiology; Diabetes, Gestational - physiopathology; Diseases of mother, fetus and pregnancy; Epidemiology; Female; General aspects; Glucose Tolerance Test; Gynecology. Andrology. Obstetrics; Health aspects; Health risk assessment; Humans; Infant, Low Birth Weight - physiology; Infant, Newborn; Insulin resistance; Italy - epidemiology; Medical sciences; Parity; Pregnancy; Pregnancy. Fetus. Placenta; Pregnant women; Prevalence; Public health. Hygiene; Public health. Hygiene-occupational medicine; Regression Analysis; Risk factors; Italy; Human; Pancreatic hormone; Statistical analysis; Pregnancy disorders; Diabetes mellitus; Low birth weight; Epidemiology; Insulin; Macrosomia; Protein hormone; Target tissue resistance; Newborn; Mother; Female; Birth weight
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/diacare.25.10.1761

Relationship Between Gestational Diabetes Mellitus and Low Maternal Birth Weight Giuseppe Seghieri , MD 1 , Roberto Anichini , MD 1 , Alessandra De Bellis , MD 1 , Lorenzo Alviggi , MD 1 , Flavia Franconi , MD 2 and Maria Cristina Breschi , MD 1 1 Department of Internal Medicine, Spedali Riuniti, Pistoia, Italy 2 Department of Pharmacology, University of Sassari, Sassari, Italy 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 = 462) or affected with GDM ( n = 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 <10th percentile (<2,600 g; n = 68) and individuals with birth weight in the >10th percentile ( n = 536). RESULTS —GDM prevalence was higher in the group in the lowest birth weight decile (<2,600 g; 24/68; 35%) than in the group with normal/high birth weight (118/536; 22%; χ 2 = 5.917; P = 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 = 1.89 [95% CI 1.088–3.285; P = 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. GDM, gestational diabetes mellitus OGTT, oral glucose tolerance test OR, odd ratio Footnotes Address correspondence and reprint requests to Giuseppe Seghieri, MD, Via Monte Sabotino 96/A, 51100 Pistoia, Italy. E-mail: gseghier{at}tin.it . Received for publication 14 January 2002 and accepted in revised form 24 June 2002. A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances. DIABETES CARE