title: Asymmetric large for gestational age newborns in pregnancies complicated by diabetes mellitus: is maternal obesity a culprit?
abstract: OBJECTIVE
  Evaluate the association between body mass index (BMI) and the delivery of an asymmetrically large for gestational age (A-LGA) newborn in women with diabetes.
  
  
  METHODS
  Retrospective analysis of 306 pregnancies complicated by Type 1 and 55 by Type 2 diabetes.
  
  
  RESULTS
  The prevalence of Type 1 and Type 2 diabetics delivering large for gestational age (LGA) infants was 42% and 49%, respectively. Of these 49% and 55% were A-LGA, respectively. Pre-pregnancy BMI was not associated with increased odds of delivering an A-LGA newborn in women with Type 1 or 2 diabetes. However, in Type 1 diabetics, each one-pound increase in maternal weight during pregnancy resulted in 4% increased odds of delivering an A-LGA newborn. For Type 2 diabetics, the odds of delivering an A-LGA infant was decreased by 10% for each 0.1 unit/kg increase in insulin dose.
  
  
  CONCLUSIONS
  Although there is a known association between obesity and LGA in women with diabetes, we found that overweight and obese women with Type 1 or Type 2 diabetes do not have increased odds of delivering an A-LGA newborn. However, insulin dose in Type 2 diabetes and maternal weight gain in Type 1 diabetes were significantly associated with the odds of delivering an A-LGA neonate.
authors.affiliation: Department of Obstetrics & Gynecology, Washington Hospital Center, MedStar Health, Washington DC, USA. maisafeghali@gmail.com
authors.forename: Maisa N
authors.initials: MN
authors.lastname: Feghali
authors.forename: Jane C
authors.initials: JC
authors.lastname: Khoury
authors.forename: Julia
authors.initials: J
authors.lastname: Timofeev
authors.forename: David
authors.initials: D
authors.lastname: Shveiky
authors.forename: Rita W
authors.initials: RW
authors.lastname: Driggers
authors.forename: Menachem
authors.initials: M
authors.lastname: Miodovnik
mesh_terms: D000328:Adult; D001724:Birth Weight; D015992:Body Mass Index; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D007328:Insulin / Q000008:administration & dosage; D009765:Obesity / Q000150:complications*; D011247:Pregnancy; D011248:Pregnancy Complications; D011254:Pregnancy in Diabetics; D015430:Weight Gain
chemical_list: D007328:Insulin