ISSN 1662-4009 (online)

ESPE Yearbook of Paediatric Endocrinology (2021) 18 2.13 | DOI: 10.1530/ey.18.2.13

Acta Diabetol. 2021 Mar;58(3):341–354. doi: 10.1007/s00592-020-01619-0. PMID: 33216207.

The key findings of this multi-centre prospective cohort study were that neonates born to mothers treated for Gestational diabetes mellitus (GDM) (by lifestyle or medication, e.g. insulin or metformin) had high rates of macrosomia but similar adiposity to those born of mothers with normal glucose tolerance. In contrast, neonates born to untreated mothers who were overweight and had a normal glucose tolerance had increased adiposity. Increased gestational weight gain was associated with increased neonatal adiposity in boys. Maternal BMI, fasting blood glucose, triglycerides and gestational weight gain were independent predictors for neonatal adiposity.

Adiposity in the newborn period has been linked to obesity in childhood and adolescence. Understanding the risk factors that contribute to neonatal adiposity might help to understand the mechanisms of obesity in childhood and adolescence and thus help in developing any preventative measures. GDM, maternal obesity, hyperglycaemia and excessive gestational weight gain and are all associated with increased newborn adiposity. In addition, cord blood C-peptide, as well as amino acids and fatty acids, are also important mediators of newborn adiposity. A previous systematic review and meta-analysis found that infants born to mothers with GDM had higher fat mass and that there was a sex difference (more in boys than in girls (1)).

The findings here suggest that implementing measures to limiting gestational weight gain and treating GDM (by lifestyle or medication) might be important especially in the male fetus to reduce the risk of neonatal adiposity and the long-term risk of obesity.

Reference: 1. Logan KM, Gale C, Hyde MJ, Santhakumaran S, Modi N. Diabetes in pregnancy and infant adiposity: systematic review and meta-analysis. Arch Dis Child Fetal Neonatal Ed. 2017 Jan;102(1):F65–F72.

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