Skip to main content
SpringerLink
Log in

Risk of LGA in pregnant women with different GDM status and risk profiles

  • Original Article
  • Published:
International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript

Abstract

Objectives

To compare risk of large-for-gestational age (LGA) infants and pregnancy outcomes between pregnant women with different gestational diabetes (GDM) status.

Methods

GDM screening was offered to 1510 women during 24–28 weeks of gestation and during first visits for those with GDM risks. Women were categorized into 3 groups: Group1: women without GDM; group2: women at-risk but did not have GDM; and group3: women with GDM. Rate of LGA and other outcomes were compared and associated factors were evaluated.

Results

A total of 408 women were in group1 (without GDM), 893 were in group2 (at-risk but without GDM), and 209 had GDM (group3). GDM women were significantly more likely to be older, multiparous, overweight/obese, have previous GDM, have less gestational weight gain, and have preeclampsia. Rates of LGA were 11.3% in group 1, 17.2% in group 2, and 22% in group 3 (p = 0.001). Independent risk of LGA was 2nd trimester weight gain > 7 kg in group1 (adjusted OR 2.65, 95%CI 1.36–5.15). In group 2, independent associated factors were overweight/obesity (adjusted OR 2.04, 95%CI 1.38–3.01) and 2nd trimester weight gain > 7 kg (adjusted OR 1.59, 95%CI 1.1–2.28). In group 3, independent associated factors were 2nd trimester weight gain > 7 kg (adjusted OR 2.3, 95%CI 1.07–4.98) and suboptimal glycemic control (adjusted OR 3.12, 95%CI 1.3–7.69).

Conclusion

Women with different GDM status had different characteristics and outcomes. Second trimester weight gain > 7 kg was the common independent risk of LGA and suboptimal glycemic control increased LGA risk in GDM women.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data availability

Not applicable.

References

  1. American College of Obstetricians and Gynecologists. Committee on Practice Bulletins-Obstetrics. Practice Bulletin No. 190: gestational diabetes mellitus. Obstet Gynecol. 2018;131(2):e49–64.

    Article  Google Scholar 

  2. American Diabetes Association. Standards of medical care in Diabetes. Diabetes Care. 2019;42(Suppl 1):S13–28.

    Article  Google Scholar 

  3. Hod M, Kapur A, Sacks DA, Hadar E, Agarwal M, Di Renzo GC, et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on gestational diabetes mellitus: a pragmatic guide for diagnosis, management, and care. Int J Gynaecol Obstet. 2015;131(Suppl 3):S173–211.

    Article  Google Scholar 

  4. Li-Zhen L, Yun X, Xiao-Dong Z, Shu-Bin H, Zi-Lian W, Adrian Sandra D, et al. Evaluation of guidelines on the screening and diagnosis of gestational diabetes mellitus: systematic review. BMJ Open. 2019;9(5):e023014.

    Article  Google Scholar 

  5. Stamilio DM, Olsen T, Ratcliffe S, Sehdev HM, Macones GA. False-positive 1-hour glucose challenge test and adverse perinatal outcomes. Obstet Gynecol. 2004;103(1):148–56.

    Article  Google Scholar 

  6. Yee LM, Cheng YW, Liddell J, Block-Kurbisch I, Caughey AB. 50-gram glucose challenge test: is it indicative of outcomes in women without gestational diabetes mellitus? J Matern Fetal Neonatal Med. 2011;24(9):1102–6.

    Article  CAS  Google Scholar 

  7. Yogev Y, Langer O, Xenakis EM, Rosenn B. The association between glucose challenge test, obesity and pregnancy outcome in 6390 non-diabetic women. J Matern Fetal Neonatal Med. 2005;17(1):29–34.

    Article  Google Scholar 

  8. Landon MB, Spong CY, Thom E, Carpenter MW, Ramin SM, Casey B, et al. A multicenter, randomized trial of treatment for mild gestational diabetes. N Engl J Med. 2009;361(14):1339–48.

    Article  CAS  Google Scholar 

  9. Carpenter MW, Coustan DR. Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol. 1982;144(7):768–73.

    Article  CAS  Google Scholar 

  10. Sunsaneevithayakul P, Boriboohirunsarn D, Sutanthavibul A, Ruangvutilert P, Kanokpongsakdi S, Singkiratana D, et al. Risk factor-based selective screening program for gestational diabetes mellitus in Siriraj Hospital: result from clinical practice guideline. J Med Assoc Thail. 2003;86(8):708–14.

    Google Scholar 

  11. Rasmussen KM, Yaktine AL, editors. Weight gain during pregnancy: reexamining the guidelines. Washington, DC: The National Academies Press; 2009.

    Google Scholar 

  12. Mikolajczyk RT, Zhang J, Betran AP, Souza JP, Mori R, Gulmezoglu AM, et al. A global reference for fetal-weight and birthweight percentiles. Lancet. 2011;377(9780):1855–61.

    Article  Google Scholar 

  13. Boriboonhirunsarn D, Sunsaneevithayakul P. Relationship between 50-g glucose challenge test and large for gestational age infants among pregnant women without gestational diabetes. J Obstet Gynaecol. 2019;39(2):141–6.

    Article  CAS  Google Scholar 

  14. Boriboonhirunsarn D. Second trimester weight gain > 7 kg increases the risk of gestational diabetes after normal first trimester screening. J Obstet Gynaecol Res. 2017;43(3):462–7.

    Article  CAS  Google Scholar 

  15. Gonzalez-Quintero VH, Istwan NB, Rhea DJ, Rodriguez LI, Cotter A, Carter J, et al. The impact of glycemic control on neonatal outcome in singleton pregnancies complicated by gestational diabetes. Diabetes Care. 2007;30(3):467–70.

    Article  CAS  Google Scholar 

  16. Mendes N, Alves M, Andrade R, Ribeiro RT, Papoila AL, Serrano F. Association between glycated albumin, fructosamine, and HbA1c with neonatal outcomes in a prospective cohort of women with gestational diabetes mellitus. Int J Gynaecol Obstet. 2019;146(3):326–32.

    Article  CAS  Google Scholar 

  17. Alexander LD, Tomlinson G, Feig DS. Predictors of large-for-gestational-age birthweight among pregnant women with type 1 and type 2 diabetes: a retrospective cohort study. Can J Diabetes. 2019;43(8):560–6.

    Article  Google Scholar 

  18. Weissgerber TL, Mudd LM. Preeclampsia and diabetes. Curr Diab Rep. 2015;15(3):9.

    Article  Google Scholar 

  19. Bodnar LM, Ness RB, Markovic N, Roberts JM. The risk of preeclampsia rises with increasing prepregnancy body mass index. Ann Epidemiol. 2005;15(7):475–82.

    Article  Google Scholar 

  20. Bodnar LM, Catov JM, Klebanoff MA, Ness RB, Roberts JM. Prepregnancy body mass index and the occurrence of severe hypertensive disorders of pregnancy. Epidemiology. 2007;18(2):234–9.

    Article  Google Scholar 

  21. Phaloprakarn C, Tangjitgamol S. Risk assessment for preeclampsia in women with gestational diabetes mellitus. J Perinat Med. 2009;37(6):617–21.

    Article  Google Scholar 

  22. Kosir Pogacnik R, Trojner Bregar A, Lučovnik M, Krajec M, Verdenik I, Blickstein I, et al. The effect of interaction between parity, gestational diabetes, and pregravid obesity on the incidence of preeclampsia. J Matern Fetal Neonatal Med. 2020;33(6):931–4.

    Article  Google Scholar 

  23. Li LJ, Yu Q, Tan KH. Clinical practice of diabetic pregnancy screening in Asia-Pacific countries: a survey review. Acta Diabetol. 2019;56(7):815–7.

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand

    Dittakarn Boriboonhirunsarn, Chompoonutch Pannin & Thamolwan Wamuk

Authors
  1. Dittakarn Boriboonhirunsarn
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chompoonutch Pannin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Thamolwan Wamuk
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

D.B., C.P., and T.W. plan and design the study together. C.P. and T.W. were responsible for data collection. D.B. analyzed the data and interpreted the results. C.P. and T.W. drafted the manuscript and D.B. revised the manuscript. All the authors approved and agreed with this final version of the manuscript.

Corresponding author

Correspondence to Dittakarn Boriboonhirunsarn.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

The study was approved by the Siriraj Institutional Review Board.

Consent to participate

Not applicable.

Consent for publication

Not applicable.

Code availability

Not applicable.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Boriboonhirunsarn, D., Pannin, C. & Wamuk, T. Risk of LGA in pregnant women with different GDM status and risk profiles. Int J Diabetes Dev Ctries 41, 511–517 (2021). https://doi.org/10.1007/s13410-020-00908-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13410-020-00908-2

Keywords

Search

Navigation