Gestational diabetes mellitus and size at birth modify early adiposity accretion. Evidence from the OBESO cohort

Aug 26, 2023Diabetes research and clinical practice

Gestational diabetes and birth size influence early fat gain in babies

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Abstract

Pregestational body mass index (preBMI) averaged 27.4 kg/m² among the studied women.

Gestational diabetes (GDM) was present in 9% of women, with 12.3% receiving medications.
One newborn was classified as large for gestational age (LGA), while 20.7% were small for gestational age (SGA).
SGA was a predictor of higher fat mass accretion from 1 to 3 months and from 1 to 6 months.
In infants, higher fat mass accretion was also observed in those with GDM from 1 to 6 months.
Infant weight and female sex were positively associated with fat mass accretion, while maternal obesity and breastfeeding were not.

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AIM: To evaluate the association between maternal obesity, gestational diabetes (GDM), and birth size with infant fat-mass (FM) accretion from 1 to 6 months (M).

METHODS: Healthy pregnant women and their term babies from the OBESO cohort were studied (1 M-3 M, n = 122; 1 M-6 M, n = 90). Registered maternal data was: pregestational body-mass-index (preBMI), GDM (2hOGTT), medications, gestational weight gain. Macrosomia (>4000 g), large/small for gestational age (LGA/SGA)(weight/age > 90° and < 90°, respectively-WHO) were recorded at birth. Infant FM (air-displacement plethysmography) was measured (1 M, 3 M, 6 M) and FM accretion computed (ΔkgFM from 1 M-3 M and 1 M-6 M). Exclusive breastfeeding (EBF) was assessed. Adjusted-multiple linear regression models were performed.

RESULTS: PreBMI was 27.4 ± 5.2 kg/m. GDM was present in9%(n = 11) of women; 12.3%(n = 15) of them received metformin/insulin. One newborn was LGA; 20.7%(n = 25) were SGA. From 1 M-3 M, SGA was a predictor of higher FM accretion (B:0.28, 95%CI:0.14-0.43); GDM was not associated. From 1 M-6 M, higher FM accretion was observed in SGA newborns (B:0.43, 95%CI:0.19-0.67) and GDM infants (B:0.48, 95%CI:0.06-0.89). In all models (R ≥ 0.48, p < 0.001), infant weight and being female were positively associated, while maternal obesity, metformin/insulin, and EBF were not. 2 2

CONCLUSIONS: GDM appears to program early higher adiposity accretion, independently of excessive fetal growth. SGA was associated with higher FM accretion in early infancy.

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Gestational diabetes mellitus and size at birth modify early adiposity accretion. Evidence from the OBESO cohort

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