History of Having a Macrosomic Infant and the Risk of Diabetes: The Japan Public Health Center-Based Prospective Diabetes Study

Yusuke Kabeya,Yumi Matsushita,Yoshihiko Takahashi,Manami Inoue,Masayuki Kato,Reury F.P Bacurau,Tetsuya Mizoue,Mitsuhiko Noda,Takashi Kadowaki,Atsushi Goto,Shoichiro Tsugane

doi:10.1371/journal.pone.0084542

Abstract

ObjectiveThe aim of the present study was to test a hypothesis that a history of having a macrosomic infant (≥4000g) is associated with the risk of diabetes.MethodsData on the Japan Public Health Center-based Prospective diabetes cohort were analyzed, which is a population-based cohort study on diabetes. The survey of diabetes was performed at baseline and at the 5-year follow-up. A history of having a macrosomic infant was assessed using a self-administered questionnaire. A cross-sectional analysis was performed among 12,153 women who participated in the 5-year survey of the cohort. Logistic regression was used to examine the relationship between a history of having a macrosomic infant and the presence of diabetes. A longitudinal analysis was also conducted among 7,300 women without diabetes who participated in the baseline survey. Logistic regression was used to investigate the relationship between a history of having a macrosomic infant and the incidence of diabetes between the baseline survey and the 5-year survey. ResultsIn the cross-sectional analysis, parous women with a positive history were more likely to have diabetes in relation to parous women without (OR = 1.44, 95% CI = 1.13-1.83). The longitudinal analysis showed a modest but non-significant increased risk of developing diabetes among women with a positive history (OR = 1.24, 95% CI = 0.80-1.94). ConclusionsAn increased risk of diabetes was implied among women with a history of having a macrosomic infant although the longitudinal analysis showed a non-significant increased risk.

Highlights

Changes in metabolic conditions occur in women during pregnancy, which enables them to supply nutrients preferentially to fetus
As for the longitudinal analysis, of the 7,300 women without diabetes at baseline, 489 (6.7%) women were nulliparous and 405 (5.5%) women had a history of having a macrosomic infant
Age, Body mass index (BMI), systolic blood pressure (BP), the proportion of diabetes, the proportion of subjects with a positive family history of diabetes and daily walking time were significantly different between the three groups

Summary

Introduction

Changes in metabolic conditions occur in women during pregnancy, which enables them to supply nutrients preferentially to fetus. Pregnancy is commonly recognized as a state of physiological and temporary insulin resistance Under such conditions, some women who have poor β-cell compensation might experience an increase in plasma glucose levels. Past studies [1,2,3] have reported that maternal diabetes and slight glucose intolerance are a risk factor for developing fetal overgrowth. It is expected that women who had a macrosomic infant were more likely to have had elevated plasma glucose levels during pregnancy than those without These women might have an underlying β-cell dysfunction and be likely to develop diabetes later in life. A medical history of having a macrosomic infant could be a risk factor of developing diabetes. There have been few studies which reported the risk estimates for the relationship between the medical history and the risk of developing diabetes

Methods

Results

Conclusion