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

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.