title: Diabetes in pregnancy and infant adiposity: systematic review and meta-analysis.
abstract: OBJECTIVE
  Maternal glycaemia and anthropometry-derived newborn adiposity are strongly correlated. The children of mothers with diabetes are at greater risk of adverse metabolic health, and increased adiposity is a plausible mediator. We undertook a systematic review and meta-analysis to compare adiposity in infants of diabetic mothers (IDM) and infants of mothers without diabetes (NIDM).
  
  
  METHODS
  We identified observational studies reporting adiposity in IDM and NIDM. We searched references, traced forward citations and contacted authors for additional data. We considered all body composition techniques and compared fat mass, fat-free mass, body fat % and skinfold thickness. We used random effects meta-analyses and performed subgroup analyses by maternal diabetes type (type 1, type 2 and gestational) and infant sex. We examined the influence of pre-pregnancy body mass index (BMI) and conducted sensitivity analyses.
  
  
  RESULTS
  We included data from 35 papers and over 24 000 infants. IDM have greater fat mass than NIDM (mean difference (95% CI)): 83 g (49 to 117). Fat mass is greater in infants of mothers with gestational diabetes: 62 g (29 to 94) and type 1 diabetes: 268 g (139 to 397). Insufficient studies reported data for type 2 diabetes separately. Compared with NIDM, fat mass was greater in IDM boys: 87 g (30 to 145), but not significantly different in IDM girls: 42 g (-33 to 116). There was no attenuation after adjustment for maternal BMI.
  
  
  CONCLUSIONS
  IDM have significantly greater adiposity in comparison with NIDM. These findings are justification for studies to determine whether measures to reduce infant adiposity will improve later health.
authors.affiliation: Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, UK.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Logan
authors.affiliation: Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Gale
authors.affiliation: Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, UK.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Hyde
authors.affiliation: Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, UK.
authors.forename: Shalini
authors.initials: S
authors.lastname: Santhakumaran
authors.affiliation: Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, UK.
authors.forename: Neena
authors.initials: N
authors.lastname: Modi
mesh_terms: D050154:Adiposity; D001724:Birth Weight; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009765:Obesity / Q000209:etiology* / Q000503:physiopathology; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000503:physiopathology*; D012307:Risk Factors
keywords: Endocrinology; Neonatology; Obesity; Outcomes research