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Issue 108 Item 10 Mother’s Birthweight Linked to Gestational Diabetes Mellitus R

Women’s own birthweight is associated with the risk for gestational diabetes mellitus. >That, according to the results of a population-based study reported in the May 15th issue of The Journal of the American Medical Association.

Dr. Kim E. Innes, from the University of Virginia, Charlottesville, and colleagues collected data on healthy women who had their first pregnancies between 1994 and 1998 in New York State and who also had been born in New York State. The researchers linked pregnancy records with birthweight records for these women.

Among these women, 440 had gestational diabetes mellitus and 22,955 women did not, the researchers found. There was a U-shaped relationship between birthweight and the risk of gestational diabetes mellitus, with the highest risk for gestational diabetes mellitus linked to low and high birthweight, they add.

For women whose birthweight was <2000 g the odds ratio, adjusted for gestational age, for having gestational diabetes mellitus was 2.16. For woman whose birthweight was 4000 g or greater the adjusted odds ratio was 1.53, the investigators note.

When Dr. Innes’s group adjusted for other confounding factors, especially prepregnancy body mass index and maternal diabetes mellitus, the odds ratio for gestational diabetes increased to 4.23 for low birthweight.

However, the risk for gestational diabetes decreased for high birthweight (odds ratio 0.92). This left a "strong inverse dose-response relationship between birthweight and risk of gestational diabetes mellitus (adjusted p for trend < 0.001)."

Dr. Innes and colleagues conclude that "the results of this study are consistent with the hypothesis that susceptibility to diabetes and related insulin resistance conditions may be programmed in utero."

"In particular, our findings suggest that early life factors, and in particular, fetal growth, may be important in the etiology of gestational diabetes mellitus."

JAMA 2002;287:2534-2541.