A new study to be presented at the Society for Maternal-Fetal Medicine’s (SMFM) annual meeting, The Pregnancy Meeting™ — and published in the American Journal of Obstetrics & Gynecology, USA shared how pregnant women with gestational diabetes are more likely to develop Type 2 diabetes later in life. Gestational diabetes (LGA) is another common cause of newborns who are too big for their gestational age. LGA infants weigh more than 90% of all infants of the same gestational age. Neonatal LGA babies were likelier to be admitted to the neonatal critical care unit and later develop health issues like Type 2 diabetes and obesity.
Whether a woman who gives birth to an LGA baby but does not have gestational diabetes is also at risk of developing diabetes in later life has not been investigated to this point. A new study suggests that pregnant women who deliver a baby significant for their gestational age but do not have diabetes are at an increased risk of developing prediabetes, also known as Type 2 diabetes—10-14 years later. This information will be presented at The Pregnancy Meeting, the meeting of the Society for Maternal-Fetal Medicine (SMFM) and published in the American Journal of Obstetrics & Gynecology,
The researchers used the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Follow-up Study. A diverse cohort in their third trimester of pregnancy was observational in a HAPO study. They observed glucose tolerance in the individuals, and the long-term health outcomes of pregnant women and their unborn children were the focus of the follow-up Study. 535 of the 4,025 women who were not diagnosed with gestational diabetes had an LGA child; A small-for-gestational-age (SGA) infant accounted for 8% (314 people); and an average-for-gestational-age (AGA) or normally grown infant accounted for 79% (3,176 people).
According to the data, between 10 and 14 years after giving birth, 791 people were diagnosed with prediabetes or diabetes. The prevalence of prediabetes or diabetes was also higher among people who had an LGA birth (24.8%) compared to those who had an SGA birth (15.4%) or, more importantly, an AGA birth (19.7%). Even after researchers adjusted for risk factors for Type 2 diabetes, such as age, obesity, high blood pressure, and a family history of diabetes, the increased risk of diabetes and prediabetes with an LGA infant remained the same.
The study’s lead author, Kartik K. Venkatesh, says, “So often in clinical practice when we see big babies, and the individual does not have gestational diabetes, we do not talk about the health consequences for the mother later in life.”
Kartik MD, PhD, is a maternal-fetal medicine subspecialist, assistant professor of obstetrics and gynaecology, and assistant professor of epidemiology at The Ohio State University Wexner Medical Center in Columbus.
However, this study suggests that even pregnant women without gestational diabetes may face health issues if their unborn child is more significant than average. Consequently, it is critical to monitor many pregnant women and their offspring over an extended period, regardless of whether or not they have gestational diabetes. By establishing these connections between pregnancy and long-term health outcomes for mothers and children, “the real implication of this research is that we need to stop thinking of pregnancy care as episodic care to see the bigger picture.”
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