Effect of Maternal Glycemia on Neonatal Adiposity in a Multiethnic Asian Birth Cohort

Abstract

A continuous relationship between maternal glycemia and excessive neonatal adiposity extends across the range of maternal glycemia. Compared with Chinese infants, Indian infants may be less susceptible to excessive adiposity from high maternal glucose levels.

The identification and treatment of women with hyperglycaemia in pregnancy: an analysis of individual participant data, systematic reviews, meta-analyses and an economic evaluation

“…The studies fall into four categories: (1) 28 studies (including BiB and Atlantic DIP) 6,61, reported associations between glucose levels (from OGTT or OGCT) split into three or more categories and adverse perinatal outcomes (see Table 7); (2) 20 studies [88][89][90][91][92][93][94][95][96][97][98][99][100][101][102][103][104][105][106][107] reported associations between glucose levels (from OGTT or OGCT) split into two categories with adverse perinatal outcomes (see Table 8) -these studies were mostly comparisons of women with lower glucose levels at OGCT [typically < 140 mg/dl (7.8 mmol/l)] compared with women with higher glucose levels at OGCT; (3) five studies 36,41,65,108,109 reported longer-term outcomes in either mother or offspring (see Table 9) (it was not possible to pool studies reporting longer-term outcomes because they were too diverse); and (4) the remaining five studies [110][111][112][113] did not present numerical data that were suitable for analysis and therefore could not be included in any of the meta-analyses (see Appendix 2, Table 63). One study 114 used a 75-g OGTT in a non-fasted population.…”

“…For all of these comparisons, the numbers of outcomes in the two groups were used to calculate ORs for outcomes comparing one group with a perceived lower risk with another group with a perceived higher risk. C-section 6,22,59,71,80,83 Induction 22,71 Instrumental birth 22,59,71 LGA 6,22,59,61,65,71,72 Macrosomia 22,59,71,80,81,83 Pre-eclampsia 22,59,69,83 Preterm birth 22,59,71 Shoulder dystocia 22,59,61,71 Neonatal hypoglycemia 71,76 PIH/Pre-eclampsia 61,71,81 C-section 6,61 LGA 6,61 Pre-eclampsia 61,69 C-section 6,22,59,71,73,77,79,…”

“…Six studies 22,36,41,65,108,109 reported longer-term and/or anthropometric outcomes, either measures of adiposity or incidence of diabetes. The characteristics of these studies are presented in Table 9.…”

“…Three studies 7,36,65 (see Chapter 2) reported neonatal obesity (skinfold thickness and percentage body fat of > 90th centile), one study 41 reported obesity at age 2 year and one study 108 reported obesity at age 5-7 years. One study, 109 in Pima Indians, reported longer-term incidence of diabetes in offspring.…”

Antenatal management of gestational diabetes mellitus can improve neonatal outcomes

“…The premise for GDM treatment is, in part, based on the assumption of a positive independent relationship between maternal glycaemia and neonatal adiposity (Catalano et al, 2003;Stuebe et al, 2012;Aris et al, 2014). The Hyperglycaemia and Adverse Pregnancy Outcomes (HAPO) study revealed strong, predominantly linear associations between maternal glycaemia and birthweight 490th percentile, per cent body fat (BF%) 490th percentile, pre-eclampsia, caesarean childbirth, shoulder dystocia and clinical neonatal hypoglycaemia (HAPO, 2008(HAPO, , 2009).…”