Gestational diabetes mellitus and size at birth modify early adiposity accretion. Evidence from the OBESO cohort

Diabetes Res Clin Pract. 2023 Sep:203:110889. doi: 10.1016/j.diabres.2023.110889. Epub 2023 Aug 25.

Abstract

Aim: To evaluate the association between maternal obesity, gestational diabetes (GDM), and birth size with infant fat-mass (FM) accretion from 1 to 6 months (M).

Methods: Healthy pregnant women and their term babies from the OBESO cohort were studied (1 M-3 M, n = 122; 1 M-6 M, n = 90). Registered maternal data was: pregestational body-mass-index (preBMI), GDM (2hOGTT), medications, gestational weight gain. Macrosomia (>4000 g), large/small for gestational age (LGA/SGA)(weight/age > 90° and < 90°, respectively-WHO) were recorded at birth. Infant FM (air-displacement plethysmography) was measured (1 M, 3 M, 6 M) and FM accretion computed (ΔkgFM from 1 M-3 M and 1 M-6 M). Exclusive breastfeeding (EBF) was assessed. Adjusted-multiple linear regression models were performed.

Results: PreBMI was 27.4 ± 5.2 kg/m2. GDM was present in9%(n = 11) of women; 12.3%(n = 15) of them received metformin/insulin. One newborn was LGA; 20.7%(n = 25) were SGA. From 1 M-3 M, SGA was a predictor of higher FM accretion (B:0.28, 95%CI:0.14-0.43); GDM was not associated. From 1 M-6 M, higher FM accretion was observed in SGA newborns (B:0.43, 95%CI:0.19-0.67) and GDM infants (B:0.48, 95%CI:0.06-0.89). In all models (R2 ≥ 0.48, p < 0.001), infant weight and being female were positively associated, while maternal obesity, metformin/insulin, and EBF were not.

Conclusions: GDM appears to program early higher adiposity accretion, independently of excessive fetal growth. SGA was associated with higher FM accretion in early infancy.

Keywords: Adiposity; Birthweight; Fetal programming; Obesity; Pediatrics.

MeSH terms

  • Adiposity
  • Birth Weight
  • Body Mass Index
  • Diabetes, Gestational*
  • Female
  • Fetal Macrosomia / complications
  • Fetal Macrosomia / etiology
  • Humans
  • Infant
  • Infant, Newborn
  • Insulins*
  • Male
  • Metformin* / therapeutic use
  • Obesity / complications
  • Obesity, Maternal* / complications
  • Pregnancy
  • Weight Gain

Substances

  • Metformin
  • Insulins