title: Disproportionate body composition and neonatal outcome in offspring of mothers with and without gestational diabetes mellitus.
abstract: OBJECTIVE
  High birth weight is a risk factor for neonatal complications. It is not known if the risk differs with body proportionality. The primary aim of this study was to determine the risk of adverse pregnancy outcome in relation to body proportionality in large-for-gestational-age (LGA) infants stratified by maternal gestational diabetes mellitus (GDM).
  
  
  METHODS
  Population-based study of all LGA (birth weight [BW] >90th percentile) infants born to women with GDM (n = 1,547) in 1998-2007. The reference group comprised LGA infants (n = 83,493) born to mothers without diabetes. Data were obtained from the Swedish Birth Registry. Infants were categorized as proportionate (P-LGA) if ponderal index (PI) (BW in grams/length in cm(3)) was ≤90th percentile and as disproportionate (D-LGA) if PI >90th percentile. The primary outcome was a composite morbidity: Apgar score 0-3 at 5 min, birth trauma, respiratory disorders, hypoglycemia, or hyperbilirubinemia. Logistic regression analysis was used to obtain odds ratios (ORs) for adverse outcomes.
  
  
  RESULTS
  The risk of composite neonatal morbidity was increased in GDM pregnancies versus control subjects but comparable between P- and D-LGA in both groups. D-LGA infants born to mothers without diabetes had significantly increased risk of birth trauma (OR 1.19 [95% CI 1.09-1.30]) and hypoglycemia (1.23 [1.11-1.37]). D-LGA infants in both groups had significantly increased odds of Cesarean section.
  
  
  CONCLUSIONS
  The risk of composite neonatal morbidity is significantly increased in GDM offspring. In pregnancies both with and without GDM, the risk of composite neonatal morbidity is comparable between P- and D-LGA.
authors.affiliation: Corresponding author: Martina Persson, martina.persson@ki.se.
authors.forename: Martina
authors.initials: M
authors.lastname: Persson
authors.forename: Helena
authors.initials: H
authors.lastname: Fadl
authors.forename: Ulf
authors.initials: U
authors.lastname: Hanson
authors.forename: Dharmintra
authors.initials: D
authors.lastname: Pasupathy
mesh_terms: D000328:Adult; D001724:Birth Weight; D001823:Body Composition; D002585:Cesarean Section; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology*; D008297:Male; D009035:Mothers; D016017:Odds Ratio; D050177:Overweight / Q000453:epidemiology*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D012307:Risk Factors