Oral Concurrent Session 9 - Diabetes
Oral Concurrent Sessions
Expedited Sessions
It is uncertain whether having a large-for-gestational age (LGA) birth is associated with increased risk for subsequent maternal diabetes in individuals without gestational diabetes mellitus (GDM). Using data from the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Follow-up Study, we estimated the association of having had an LGA birth with developing prediabetes and diabetes 10 to 14 years’ postpartum among those without GDM.
Study Design: Pregnant individuals without GDM in the HAPO Follow-up Study were included. The primary exposure was birthweight category [LGA (>90th percentile), small-for gestational-age (SGA, < 10th percentile), and appropriate for gestational age (AGA) as the reference], accounting for gestational age at birth and infant sex, per the INTERGROWTH-21st international fetal growth standard. The outcome was having developed either prediabetes or diabetes by 10 to 14 years’ after delivery. Poisson regression with robust error variance was used and adjusted for baseline maternal covariates: age, parity, body mas index, height, family history of diabetes, mean arterial pressure, smoking status, and alcohol use.
Results: Among 4,025 individuals without GDM (median [IQR] age: 30.2 [25.7, 33.8] years), 13.2% (n=535) had a LGA infant, 7.8% (n=314) had a SGA infant, and 78.9% (n=3,176) had an AGA infant. A fifth (20.0%, n=791) were diagnosed with prediabetes or diabetes by 10 to 14 years’ after delivery. The frequency of prediabetes or diabetes was higher among individuals who had a LGA birth (24.8%) and lower among those who had a SGA birth (15.4%) compared with those who had an AGA birth (19.7%) (overall p< 0.01) (Table 1). In multivariable analyses, individuals who had a LGA birth were at higher risk of having prediabetes or diabetes compared with those who had an AGA birth (adjusted risk ratio, aRR: 1.21; 95% CI: 1.02 to 1.44) (Table 2). SGA birth was not associated with the outcome.
Conclusion: Among individuals without GDM, having a prior LGA infant increased the risk of being diagnosed with prediabetes or diabetes by 10 to 14 years’ postpartum.
Kartik Kailas Venkatesh, MD, PhD (he/him/his)
Assistant Professor
The Ohio State University
Columbus, Ohio, United States
William A. Grobman, MD, MBA
Vice Chair, Clinical Operations, Maternal Fetal Medicine
The Ohio State University
Columbus, Ohio, United States
Jiquiang Wu, MSc
The Ohio State University Wexner Medical Center
The Ohio State University Wexner Medical Center, OH, United States
Patrick Catalano, MD
Professor
Tufts Medical Center, Mother Infant Research Institute
Boston, Massachusetts, United States
Mark B. Landon, MD
Richard L. Meiling Professor and Chair, Obstetrics and Gynecology
The Ohio State University
Columbus, Ohio, United States
Denise Sholtens, PhD
Northwestern University
Chicago, Illinois, United States
William Lowe, MD
Northwestern University
Chicago, Illinois, United States
Sadiya S. Khan, MD, MSc
Assistant Professor of Medicine
Northwestern University Feinberg School of Medicine
Oak Park, IL, United States