The association of insufficient gestational weight gain in women with gestational diabetes mellitus with adverse infant outcomes: A case-control study

Dabin Huang; Mulin Liang; Bin Xu; Shan Chen; Yan Xiao; Hui Liu; Dan Yin; Jun Yang; Ling Wang; PianPian Pan; Yihui Yang; Wei Zhou; Juncao Chen

doi:10.3389/fpubh.2023.1054626

The association of insufficient gestational weight gain in women with gestational diabetes mellitus with adverse infant outcomes: A case-control study

Front Public Health. 2023 Feb 23:11:1054626. doi: 10.3389/fpubh.2023.1054626. eCollection 2023.

Authors

Dabin Huang¹, Mulin Liang², Bin Xu³, Shan Chen¹, Yan Xiao¹, Hui Liu¹, Dan Yin⁴, Jun Yang⁵, Ling Wang¹, PianPian Pan¹, Yihui Yang¹, Wei Zhou^{1

2}, Juncao Chen¹

Affiliations

¹ Department of Neonatology, Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, Guangzhou, China.
² Department of Neonatology, The Fifth Affiliated Hospital of Southern Medical University, Guangzhou, China.
³ Medical Department, The First People's Hospital of Chenzhou, Chenzhou, China.
⁴ Rehabilitation Medicine Center, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, China.
⁵ Advanced Institute of Natural Sciences, Beijing Normal University at Zhuhai, Zhuhai, China.

Abstract

Background: To investigate the association between insufficient maternal gestational weight gain (GWG) during dietary treatment, and neonatal complications of small-for-gestational-age (SGA) infants born to mothers with Gestational diabetes mellitus (GDM).

Methods: A retrospective case-control study was conducted, involving 1,651 infants born to mothers with GDM. The prevalence of a perinatal outcome and maternal GWG were compared among SGA, adequate- (AGA), and large-for-gestational-age (LGA); association with birth weight and GWG was identified using Pearson's correlation analysis; binary logistic regression was performed to determine the odds ratio (OR) associated with SGA.

Results: In total, 343 SGA, 1025 AGA, and 283 LGA infants met inclusion criteria. The frequency of SGA infants who were siblings (41.7 vs. 4.3 vs. 1.9%) and composite of complications (19.2 vs. 12.0 vs. 11.7%) were higher in SGA infants than in those in AGA or LGA infants group (both P < 0.01). GWG and pre-partum BMI were lower among the SGA mothers with GDM group (11.7 ± 4.5 kg, 25.2 ± 3.1 kg/m²) than AGA (12.3 ± 4.6 kg, 26.3 ± 3.4 kg/m²) or LGA (14.0 ± 5.1 kg, 28.7 ± 3.9 kg/m²) mothers with GDM group. Binary logistic regression showed that siblings who were SGA (AOR 18.06, 95% CI [10.83-30.13]) and preeclampsia (AOR 3.12, 95% CI [1.34-7.30]) were associated with SGA, but not GWG below guidelines (P > 0.05). The risk of SGA (25.7 vs. 19.1 vs. 14.2%) and FGR (15.3 vs. 10.9 vs. 7.8%) was higher in GWG below guidelines group than those in GWG above and within guidelines group, the risk of low Apgar score (6.4 vs. 3.0 vs. 2.8%) was higher in GWG above guidelines group than that in GWG below and within guidelines group (P < 0.05).

Conclusion: Our findings demonstrated that GWG above and below guidelines, compared with GWG within guidelines, had a higher risk of adverse infant outcomes. Our findings also suggested that GWG below guidelines did not increase the risk for SGA, though SGA infants had more adverse outcomes among neonates born to mothers with GDM.

Keywords: dietary intervention; gestational diabetes mellitus; gestational weight gain; neonatal complications; risk factors; small-for-gestational age.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Birth Weight
Case-Control Studies
Diabetes, Gestational* / epidemiology
Female
Gestational Weight Gain*
Humans
Infant
Infant, Newborn
Mothers
Pregnancy
Retrospective Studies
Weight Gain

Grants and funding

This article was supported by Research foundation of Guangzhou Women and Children's Medical Center for Clinical Doctor and Basic research program and applied basic research project of Guangzhou Science and Technology Bureau (2210124-03).