Birth of Large-for-Gestational Age Infants Increases the Risk of Type 2 Diabetes for Mothers

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Gestational diabetes, a type of diabetes that develops during pregnancy, is known to increase the risk of Type 2 diabetes for pregnant people later in life. In addition, gestational diabetes is a common cause of delivering large-for-gestational-age (LGA) babies. LGA infants are defined as those who weigh more than 90 percent of all babies of the same gestational age. These babies are more likely to have health complications later in life, including obesity and Type 2 diabetes.

However, until now, it was unclear whether someone who does not have gestational diabetes but delivers an LGA baby is also at risk of developing diabetes later in life. A new study, presented at the Society for Maternal-Fetal Medicine’s annual meeting and published in the American Journal of Obstetrics & Gynecology, has found that pregnant people who do not have diabetes but give birth to an LGA baby are at an increased risk of developing prediabetes or Type 2 diabetes 10-14 years later.

The study used data from the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Follow-up Study, which examined glucose tolerance in a large, multi-national, racially diverse cohort in their third trimester of pregnancy. The Follow-up Study looked at the association between gestational diabetes and the long-term health outcomes of pregnant people and their children. Among the 4,025 individuals who did not have gestational diabetes, 13 percent had an LGA infant, 8 percent had a small-for-gestational age (SGA) infant, and 79 percent had an average-for-gestational age (AGA) or normally grown infant.

The data revealed that 10 to 14 years after giving birth, 20 percent were diagnosed with prediabetes or diabetes, and the frequency of prediabetes or diabetes was higher among people who had an LGA birth compared to those who had an SGA birth or those who had an AGA birth. The increased risk of diabetes and prediabetes with an LGA infant was the case even after researchers adjusted for risk factors for developing Type 2 diabetes.

The study’s lead author, Kartik K. Venkatesh, MD, PhD, a maternal-fetal medicine subspecialist and assistant professor of obstetrics and gynecology and assistant professor of epidemiology at The Ohio State University Wexner Medical Center in Columbus, notes the importance of making connections between pregnancy and long-term health outcomes in mothers and children. He suggests that it is vital to follow large groups of people and their babies, regardless of whether they had gestational diabetes or not, over a long period of time to see the bigger picture. The research suggests that healthcare providers need to stop thinking of pregnancy care as episodic care and consider the health consequences for the mother later in life, even when they do not have gestational diabetes, but deliver an LGA baby.

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