Effects of hyperglycaemia in pregnancy and relevant factors on neonatal body composition

Abstract

To compare body composition at birth in the appropriate-for-gestational-age infants of women with gestational diabetes mellitus (GDM) and normal glucose tolerance and determine the influencing factors of body composition in infants of women with GDM and normal glucose tolerance. A study was conducted on 160 appropriate-for-gestational-age infants (90 males and 70 females) of women with gestational diabetes mellitus (GDM group) and 284 appropriate-for-gestational-age infants (139 males and 145 females) of women with normal glucose tolerance (control group). Anthropometric measurements were obtained within 24 to 48 hours of birth. Multiple stepwise regression was used to determine the correlating factors of fat mass, percent of body fat and fat free mass mass. There were no significant difference in gestational age, birth weight, length, body mass index, circumferences of head, chest and upper arm, biceps, abdominal superficial skin fold between two groups (all P > 0.05), but GDM group was characterized by higher skin folds of triceps and subscapular and flank versus control group(all P = 0.000). GDM group had greater fat mass but decreased fat free mass versus control group ((585 ± 59) vs (480 ± 74) g, 17.8% ± 0.8% vs 14.7% ± 1.9%, (2685 ± 127) vs (2784 ± 109) g, all P = 0.000). Stepwise regression showed that maternal fasting glucose level of oral glucose tolerance test and pre-gravid body mass index correlated with fat mass and percent of body fat. Fasting glucose level had the strongest correlation with fat mass and percent of body fat (P = 0.004, 0.006). Gestational age and maternal height correlated with fat free mass in GDM group (P = 0.040, 0.013). On the other hand, maternal weight gain correlated with fat mass (P = 0.015), fasting glucose level and maternal prepartal weight were correlated with percent of body fat (P = 0.002, 0.043) and pre-gravid body mass index had correlation with fat free mass in control group (P = 0.004). The appropriate-for-gestational-age infants of women with GDM have increased fat mass and percent of body fat, but decreased fat free mass. Maternal fasting glucose level of oral glucose tolerance test, pre-gravid body mass index, weight gain and maternal prepartal weight are influencing factors of body composition in neonates.