Endocrine Abstracts

Introduction: Gestational diabetes mellitus (GDM) is an increasing problem worldwide. Post-natal-hypoglycaemia and excess-foetal-growth are known important metabolic complications of neonates born to women with diabetes. This retrospective-cohort-study aims to determine the influence of obesity and glucose-intolerance on neonatal-hypoglycaemia and birth-weight over the 90th percentile (LGA).

Methods: Data were abstracted from 303 patient medical records from singleton pregnancies diagnosed with GDM. Data were recorded during routine hospital visits. Demographic data were acquired by facilitated questionnaires and anthropometrics measured at the first antenatal appointment. Blood-biochemical-indices were recorded. Plasma glucose area under the curve (PG-AUC) was calculated from 75 g oral glucose tolerance (OGTT) results as an index of glucose intolerance.

Results: OGTT results of 303 pregnant women aged between 33.6 y (29.8–37.7), diagnosed with GDM were described. Neonates of mothers with a BMI of over 30 kg.m^-2 were more likely to experience neonatal hypoglycaemia (24 (9.2%) vs 23 (8.8%), P = 0.016) with odds-ratio for neonatal-hypoglycaemia significantly higher at 2.105, 95% CI (1.108,4.00), P = 0.023. ROC analysis showed poor strength of association (AUC 0.587 (95% CI, .487 to .687). Neonatal LGA was neither associated with nor predicted PG-AUC or obesity; however, multiparous women were 2.8 (95% CI (1.14, 6.78), P = 0.024) times more likely to have a baby born LGA.

Conclusion: Maternal BMI during the first trimester of pregnancy exhibits a strong influence on neonatal hypoglycaemia but not neonatal birthweight in a cohort of pregnancies affected by GDM. Multiparous women are more likely to have an infant born LGA. Future studies should examine the relationship between maternal adiposity, together with accurate markers of insulin sensitivityon the outcome of neonatal hypoglycaemia.