title: Large-for-gestational-age (LGA) neonate predicts a 2.5-fold increased odds of neonatal hypoglycaemia in women with type 1 diabetes.
abstract: The objective of the study is to assess the impact of maternal glycaemic control and large-for-gestational-age (LGA) infant size on the risk of developing neonatal hypoglycaemia in offspring of women with type 1 diabetes and to determine possible predictors of neonatal hypoglycaemia and LGA.
  
  
  
  This retrospective cohort study evaluated pregnancies in 161 women with type 1 diabetes mellitus at a large urban centre between 2006 and 2010. Mean trimester A1cvalues were categorized into five groups. Multiple logistic regression analyses were used to examine predictors of neonatal hypoglycaemia and large-for-gestational-age (LGA).
  
  
  
  Hypoglycaemia occurred in 36.6% of neonates. There was not a linear association between trimester specific A1cand LGA. After adjusting for maternal age, body mass index (BMI), smoking and premature delivery, neonatal hypoglycaemia was not linearly associated with A1cin the first, second or third trimesters. LGA was the only significant predictor for neonatal hypoglycaemia (OR, 95% CI 2.51 [1.10, 5.70]) in logistic regression analysis that adjusted for glycaemic control, maternal age, smoking, prematurity and BMI. An elevated third trimester A1cincreased the odds of LGA (1.81 [1.03, 3.18]) after adjustment for smoking, parity and maternal BMI.
  
  
  
  Large-for-gestational-age imparts a 2.5-fold increased odds of hypoglycaemia in neonates of women with type 1 diabetes and may be a better predictor of neonatal hypoglycaemia than maternal glycaemic control. Our data suggest that LGA neonates of women with type 1 diabetes should prompt increased surveillance for neonatal hypoglycaemia and that the presence of optimum maternal glycaemic control should not reduce this surveillance. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Department of Medicine, Division of Endocrinology and Metabolism, University of Calgary, Calgary, AB, Canada.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Yamamoto
authors.affiliation: Department of Medicine, Division of Endocrinology and Metabolism, University of Calgary, Calgary, AB, Canada.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Kallas-Koeman
authors.affiliation: Department of Medicine, Division of Endocrinology and Metabolism, University of Calgary, Calgary, AB, Canada.
authors.forename: Sonia
authors.initials: S
authors.lastname: Butalia
authors.affiliation: Section of Neonatology, Department of Pediatrics & Community Health Sciences, University of Calgary, Calgary, AB, Canada.|Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.
authors.forename: Abhay K
authors.initials: AK
authors.lastname: Lodha
authors.affiliation: Department of Medicine, Division of Endocrinology and Metabolism, University of Calgary, Calgary, AB, Canada.
authors.forename: Lois E
authors.initials: LE
authors.lastname: Donovan
mesh_terms: D000328:Adult; D049628:Body Size; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D016640:Diabetes, Gestational / Q000503:physiopathology*; D005260:Female; D005320:Fetal Macrosomia / Q000150:complications*; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology*; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies; D012307:Risk Factors
keywords: hypoglycaemia; large-for-gestational-age; neonates; pregnancy; type 1 diabetes