title: The association between maternal insulin resistance in mid-pregnancy and neonatal birthweight in uncomplicated pregnancies.
abstract: There have been few studies performed to address the association between the degree of physiological increase in maternal insulin resistance during pregnancy and neonatal birthweight in non-diabetic pregnancy. We attempted to determine whether maternal insulin resistance, as measured by homeostasis model assessment-insulin resistance (HOMA-IR), in mid-pregnancy is associated with neonatal birthweight in normal pregnancies. In this retrospective observational study, we measured HOMA-IR in singleton healthy pregnant women who underwent a 75 g oral glucose tolerance test (OGTT) in mid-pregnancy because of a positive diabetes screen. Using multivariate analyses to adjust for maternal parity, pre-gestational obesity, gestational weight gain, plasma glucose levels, and gestational age at delivery, we tested the association between HOMA-IR and birthweight in their offspring. We also tested the association HOMA-IR and a risk of large-for-gestational-age (LGA) infants. In 655 Japanese women, HOMA-IR was positively associated with birthweight after adjusting for these confounders (p<0.05). A higher HOMA-IR was significantly associated with an increased incidence of LGA infants with an adjusted odds ratio of 1.53 (95% confidence interval, 1.10-2.15) per 1 unit of HOMA-IR. The degree of maternal insulin resistance in mid-pregnancy was associated with birthweight and the risk of giving birth to an LGA infant in normal pregnancies, independent of maternal obesity and glucose levels.
authors.affiliation: Department of Obstetrics and Gynecology, NHO Nagasaki Medical Center, Omura 856-8562, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamashita
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yasuhi
authors.forename: Masashi
authors.initials: M
authors.lastname: Fukuda
authors.forename: Yukari
authors.initials: Y
authors.lastname: Kugishima
authors.forename: Yuki
authors.initials: Y
authors.lastname: Yamauchi
authors.forename: Akiko
authors.initials: A
authors.lastname: Kuzume
authors.forename: Takashi
authors.initials: T
authors.lastname: Hashimoto
authors.forename: So
authors.initials: S
authors.lastname: Sugimi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Umezaki
authors.forename: Sachie
authors.initials: S
authors.lastname: Suga
authors.forename: Nobuko
authors.initials: N
authors.lastname: Kusuda
mesh_terms: D000328:Adult; D001724:Birth Weight / Q000502:physiology*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007231:Infant, Newborn; D007333:Insulin Resistance / Q000502:physiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies