title: The impact of abnormal glucose tolerance and obesity on fetal growth.
abstract: OBJECTIVE
  Factors linked with insulin resistance were examined for their association with large-for-gestational-age (LGA) infant birth weight and gestational diabetes.
  
  
  METHODS
  Data came from a longitudinal cohort study of 2,305 subjects without overt diabetes, analyzed using multinomial logistic and linear regression.
  
  
  RESULTS
  High maternal BMI (OR = 1.53 (1.11, 2.12)), height (1.98 (1.62, 2.42)), antidepressant use (1.71 (1.20, 2.44)), pregnancy weight-gain exceeding 40 pounds (1.79 (1.25, 2.57)), and high blood sugar (2.68, (1.53, 5.27)) were all positively associated with LGA birth. Strikingly, the difference in risk from diagnosed and treated gestational diabetes compared to women with a single abnormal glucose tolerance test (but no diagnosis of gestational diabetes) was significant (OR = 0.65, p = 0.12 versus OR = 2.84, p < 0.01). When weight/length ratio was used instead, different factors were found to be significant. BMI and pregnancy weight-gain were found to influence the development of gestational diabetes, through an additive interaction.
  
  
  CONCLUSIONS
  High prepregnancy BM, height, antidepressant use, pregnancy weight-gain exceeding 40 pounds, and high blood sugar were associated with LGA birth, but not necessarily infant weight/length ratio. An additive interaction between BMI and pregnancy weight-gain influenced gestational diabetes development.
authors.affiliation: Department of Epidemiology and Biostatistics, Western University, London, ON, Canada N6A 5C1.
authors.forename: Erin
authors.identifier: 0000-0002-1518-0564
authors.initials: E
authors.lastname: Graves
authors.affiliation: Department of Physiology and Pharmacology, Western University, London, ON, Canada N6A 5C1 ; Lawson Health Research Institute, London, ON, Canada N6C 2R5.
authors.forename: David J
authors.initials: DJ
authors.lastname: Hill
authors.affiliation: Department of Family Relations and Applied Nutrition, Guelph, ON, Canada N1G 2W1.
authors.forename: Susan
authors.initials: S
authors.lastname: Evers
authors.affiliation: Department of Epidemiology and Biostatistics, Western University, London, ON, Canada N6A 5C1.
authors.forename: Kristine
authors.initials: K
authors.lastname: Van Aarsen
authors.affiliation: Department of Epidemiology and Biostatistics, Western University, London, ON, Canada N6A 5C1.
authors.forename: Brie
authors.initials: B
authors.lastname: Yama
authors.affiliation: Department of Epidemiology and Biostatistics, Western University, London, ON, Canada N6A 5C1.
authors.forename: Su
authors.initials: S
authors.lastname: Yuan
authors.affiliation: Department of Epidemiology and Biostatistics, Western University, London, ON, Canada N6A 5C1 ; Lawson Health Research Institute, London, ON, Canada N6C 2R5 ; Department of Obstetrics and Gynaecology, Western University, London, ON, Canada N6H 5W9 ; Department of Paediatrics, Western University, London, ON, Canada N6C 2R6 ; Children's Health Research Institute, London, ON, Canada N6C 2V5.
authors.forename: M Karen
authors.initials: MK
authors.lastname: Campbell
mesh_terms: D000328:Adult; D001724:Birth Weight; D015992:Body Mass Index; D016640:Diabetes, Gestational / Q000378:metabolism*; D005260:Female; D047109:Fetal Development / Q000502:physiology*; D005865:Gestational Age; D018149:Glucose Intolerance / Q000150:complications / Q000378:metabolism*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D009765:Obesity / Q000150:complications / Q000378:metabolism*; D011247:Pregnancy