Abstract

INTRODUCTION

Obesity and dysregulation in glucose metabolism are risk factors for excessive fetal growth, but their combined effect are not often examined in a single study.

METHODS

Data from the Centers for Disease Control and Prevention (CDC)’s Pregnancy Risk Assessment Monitoring System (PRAMS) Phase 7 (2012-2015) were used. Logistic regression was used to investigate the association between maternal prepregnancy BMI and pre-existing diabetes /gestational diabetes on the odds of delivering an LGA or macrosomic infant.

RESULTS

Complete data for 128,199 singleton births were used. The proportions of LGA and macrosomic infants increased with the degree of obesity (p<0.001) and were higher in women with diabetes than non-diabetics (p<0.001). Compared to normal-weight women, the adjusted odds ratio (AOR) of delivering an LGA and macrosomic infants among morbidly obese (BMI ≥ 40) were 2.82 (p<0.001) and 2.67 (p<0.001), respectively. Compared to non-diabetic women, the AOR of delivering an LGA infant was 1.88 (p<0.001) among those with pre-existing diabetes and 1.49 (p<0.001) with gestational diabetes. Except for the underweight group, women with pre-existing diabetes were nearly twice as likely to deliver an LGA infant as those with similar BMI without diabetes. Compared to non-diabetics with normal BMI, morbidly obese women with gestational diabetes were twice as likely to have an LGA and a macrosomic infant.

CONCLUSIONS

We have demonstrated that when maternal obesity and diabetes, particularly pre-existing diabetes, occur together, the risk of delivering LGA and macrosomia increases significantly. Our findings call for public health attention to address maternal obesity and diabetes to minimize sub-optimal fetal growth.

Sources: https://www.sciencedirect.com/science/article/pii/S2773065423000081