(867) Endocrine diseases among macrosomic infants of diabetic mothers: add insult to injury ?

Included in this population-based cohort study were deliveries of macrosomic infants (birthweight above 4 kilograms) taking place between the years 1991 to 2021 at a tertiary referral hospital. Rates of total endocrine morbidity and specifically obesity of offspring of both diabetic and non-diabetic mothers were assessed. A Kaplan Meier survival curve compared cumulative morbidity. A Cox proportional hazards model was used to control for confounders.

Results:

A total of 16,466 infants diagnosed with macrosomia were included in the analyses, 11.1% of them were of diabetic mothers (pregestational and gestational diabetes mellitus). Total endocrine-related hospitalizations as well as childhood obesity rates were higher among macrosomic infants of diabetes mothers (p < 0.001 for both; Table). The exposed group (i.e. macrosomic offspring of diabetic mothers) also had higher cumulative incidence of hospitalizations as shown in the Kaplan-Meyer survival curves (log rank p-value < 0.001 for both; Figure). These associations between diabetes mellitus, endocrine morbidity as well as obesity remained significant in the Cox proportional hazards model (Table), controlling for maternal age, gestational age and hypertensive disorders.

Conclusion:

Diabetes mellitus during pregnancy is additive to macrosomia with regards to long-term metabolic effects of the offspring.