Future risk of metabolic syndrome in women with a previous LGA delivery stratified by gestational glucose tolerance: a prospective cohort study

BMC Pregnancy Childbirth. 2018 Aug 10;18(1):326. doi: 10.1186/s12884-018-1958-z.

Abstract

Background: Whether the delivery of a large-for-gestational-age (LGA) infant predicts future maternal metabolic syndrome (MetS) is not known. To this aim, we investigated the incidence of MetS and its components in women with or without a history of gestational diabetes mellitus (GDM) with a view to the birth weight of the offspring.

Methods: Eight hundred seventy six women treated for their pregnancies in Kuopio University Hospital in 1989-2009 underwent a follow-up study (mean follow-up time 7.3 (SD 5.1) years), of whom 489 women with GDM and 385 normoglycemic controls. The women were stratified into two groups according to the newborn's birth weight: 10-90th percentile (appropriate-for-gestational-age; AGA) (n = 662) and > 90th percentile (LGA) (n = 116). MetS and its components were evaluated in the follow-up study according to the International Diabetes Federation criteria.

Results: LGA vs. AGA delivery was associated with a higher incidence of MetS at follow-up in women with a background of GDM (54.4% vs. 43.6%), but not in women without GDM.

Conclusion: An LGA delivery in women with GDM is associated with a higher risk of future MetS and this group is optimal to study preventive measures for MetS. In contrast, an LGA delivery after a normoglycemic pregnancy was not associated with an increased future maternal MetS risk.

Keywords: Birth weight; Gestational diabetes mellitus; Large-for-gestational-age; Metabolic syndrome.

MeSH terms

  • Adult
  • Case-Control Studies
  • Cohort Studies
  • Diabetes, Gestational / epidemiology*
  • Female
  • Fetal Macrosomia / epidemiology*
  • Finland / epidemiology
  • Follow-Up Studies
  • Humans
  • Incidence
  • Metabolic Syndrome / epidemiology*
  • Pregnancy
  • Prospective Studies
  • Risk Factors
  • Young Adult