Asymmetric large for gestational age newborns in pregnancies complicated by diabetes mellitus: is maternal obesity a culprit?

Abstract

Objective: Evaluate the association between body mass index (BMI) and the delivery of an asymmetrically large for gestational age (A-LGA) newborn in women with diabetes. Methods: Retrospective analysis of 306 pregnancies complicated by Type 1 and 55 by Type 2 diabetes. Results: The prevalence of Type 1 and Type 2 diabetics delivering large for gestational age (LGA) infants was 42% and 49%, respectively. Of these 49% and 55% were A-LGA, respectively. Pre-pregnancy BMI was not associated with increased odds of delivering an A-LGA newborn in women with Type 1 or 2 diabetes. However, in Type 1 diabetics, each one-pound increase in maternal weight during pregnancy resulted in 4% increased odds of delivering an A-LGA newborn. For Type 2 diabetics, the odds of delivering an A-LGA infant was decreased by 10% for each 0.1 unit/kg increase in insulin dose. Conclusion: Although there is a known association between obesity and LGA in women with diabetes, we found that overweight and obese women with Type 1 or Type 2 diabetes do not have increased odds of delivering an A-LGA newborn. However, insulin dose in Type 2 diabetes and maternal weight gain in Type 1 diabetes were significantly associated with the odds of delivering an A-LGA neonate.

Keywords::

• LGA
• overweight
• type 1 diabetes
• type 2 diabetes

Declaration of interest: This work is supported in part by Diabetes in Pregnancy Program Project Grant (PPG), HD11725, funded from 1978 to 1995 by the National Institutes of Health, U.S.P.H.S. Grant Number MO1 RR 08084, General Clinical Research Centers Program, National Center for Research Resources and by an Institutional Clinical and Translational Science Award, NIH/NCRR Grant Number 5UL1RR026314. The contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.