Demographic and Clinical Features of Small-for-Gestational-Age Infants Born to Mothers With Gestational Diabetes Mellitus.

Juncao Chen,Weineng Lu,Xiaoqi Yang,Huimin Xiao,Longguang Huang,Wei Zhou,Yong Yang,Xiaoping Liu,Zhe Zhang,Jie Yao,Yaping Tang

doi:10.3389/fped.2021.741793

Abstract

We studied the demographic and clinical characteristic, risk factors, outcomes of full-term small-for-gestational-age (SGA) infants born to mothers with gestational diabetes mellitus (GDM) in China. A retrospective case-control study that included 1981 SGA infants was conducted; the demographic and clinical data between SGA infants born to mothers with and without GDM were compared. Of 383 SGA infants born to mothers with GDM, 221 (57.7%) were female, and the incidence of these infants was 1 in 155 live births. The risk of SGA siblings (RR, 1.88; 95% CI, [1.23–2.86]), low 1- and 5-min Apgar scores (RR,2.04 and 4.21; 95%CI [1.05–4.00] and [1.05–16.89], respectively), early thrombocytopenia (RR, 3.39; 95%CI, [1.33–8.64]), hypoglycemia(RR, 2.49; 95%CI, [1.55–3.98]), and hypoxic-ischemic encephalopathy (RR,5.61; 95%CI, [1.25–25.18]) were increased in SGA infants born to mothers with GDM compared to SGA infants born to mothers without GDM. SGA girls born to mothers with GDM had a significantly higher ratio of catch-up growth (CUG) (RR, 1.73; 95%CI, [1.18–2.54]) in the first year of life. These results show that genetic factors may be one of the etiologies of SGA infants born to mothers with GDM; and these infants have more adverse perinatal outcomes compared to SGA infants born to mothers without GDM. SGA girls born to mothers with GDM had accelerated CUG in the first year of life.

Highlights

Gestational diabetes mellitus (GDM) is a major public health problem for women in China and worldwide [1]
Of 160,474 infants that were screened in our study from 2008 to 2018, 16,059 were small- for-gestational-age (SGA) infants (10.0%, SGA was defined as birth weights ≤10th percentile for the gestational age based upon defined standards for males and females), 15,726 infants born to mothers with GDM(9.8%)
Of 160,474 infants that were screened, 1,034 were SGA infants born to mothers with GDM (0.6%), which yielded an incidence for full-term SGA infants born to mothers with GDM of approximately 1 in 155 live births

Summary

Introduction

Gestational diabetes mellitus (GDM) is a major public health problem for women in China and worldwide [1]. Fetuses receive increased amounts of glucose from mothers with GDM during pregnancy, which promotes insulin secretion and increases fetal growth. An epidemiological study found that 7% of infants whose mothers had GDM were small- for-gestational-age (SGA) in the United States [2]. The term of SGA refers to infants with birth weights (BW) below the 10th percentile for gestational age [3]. There have been no Characteristics of SGA Infants studies in China on the incidence of SGA infants born to mothers with GDM. The causes of SGA include genetic and environmental factors, but the cause of SGA infants born to mothers with GDM is unknown

Results

Discussion

Conclusion