M Persson1, D Pasupathy, U Hanson, M Norman. 1. Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden. martina.persson@ki.se
Abstract
OBJECTIVE: To determine if disproportionate body composition is a risk factor for perinatal complications in large-for-gestational-age infants born to mothers with type 1 diabetes. DESIGN: Population-based cohort study. SETTING: Data from the Swedish Medical Birth Registry from 1998 to 2007. POPULATION: National cohort of 3517 infants born to mothers with type 1 diabetes. Only singletons with gestational age 32-43 weeks were included. METHODS: Large for gestational age (LGA) was defined as birthweight > 90th centile and appropriate for gestational age (AGA) as birthweight between 10th and 90th centiles. Disproportionate (D) infants were defined as having a ponderal index [PI: calculated as birthweight in grams/(length in cm)(3) > 90th centile] and proportionate (P) as PI ≤ 90th centile. LGA infants were classified as P-LGA or D-LGA. Odds ratios were calculated for D-LGA and P-LGA infants, with AGA infants as the reference category. Odds ratios were adjusted for mode of delivery, fetal distress and stratified by gestational age. MAIN OUTCOME MEASURES: The primary outcome was a composite of neonatal morbidities, i.e. any of the following diagnoses: Apgar score < 7 at 5 minutes, birth trauma (Erb's palsy or clavicle fracture), respiratory disorder, hyperbilirubinaemia or hypoglycaemia requiring treatment. RESULTS: Composite morbidity was significantly more frequent in LGA as opposed to AGA infants, but there was no difference in risk between P-LGA and D-LGA infants. CONCLUSIONS: High birthweight, irrespective of body proportionality, is a risk factor for neonatal complications in offspring of women with type 1 diabetes.
OBJECTIVE: To determine if disproportionate body composition is a risk factor for perinatal complications in large-for-gestational-age infants born to mothers with type 1 diabetes. DESIGN: Population-based cohort study. SETTING: Data from the Swedish Medical Birth Registry from 1998 to 2007. POPULATION: National cohort of 3517 infants born to mothers with type 1 diabetes. Only singletons with gestational age 32-43 weeks were included. METHODS: Large for gestational age (LGA) was defined as birthweight > 90th centile and appropriate for gestational age (AGA) as birthweight between 10th and 90th centiles. Disproportionate (D) infants were defined as having a ponderal index [PI: calculated as birthweight in grams/(length in cm)(3) > 90th centile] and proportionate (P) as PI ≤ 90th centile. LGA infants were classified as P-LGA or D-LGA. Odds ratios were calculated for D-LGA and P-LGA infants, with AGA infants as the reference category. Odds ratios were adjusted for mode of delivery, fetal distress and stratified by gestational age. MAIN OUTCOME MEASURES: The primary outcome was a composite of neonatal morbidities, i.e. any of the following diagnoses: Apgar score < 7 at 5 minutes, birth trauma (Erb's palsy or clavicle fracture), respiratory disorder, hyperbilirubinaemia or hypoglycaemia requiring treatment. RESULTS: Composite morbidity was significantly more frequent in LGA as opposed to AGA infants, but there was no difference in risk between P-LGA and D-LGA infants. CONCLUSIONS: High birthweight, irrespective of body proportionality, is a risk factor for neonatal complications in offspring of women with type 1 diabetes.
Authors: Sharon T Mackin; Scott M Nelson; Joannes J Kerssens; Rachael Wood; Sarah Wild; Helen M Colhoun; Graham P Leese; Sam Philip; Robert S Lindsay Journal: Diabetologia Date: 2018-01-11 Impact factor: 10.122
Authors: Karl Kristensen; Linda E Ögge; Verena Sengpiel; Karin Kjölhede; Annika Dotevall; Anders Elfvin; Filip K Knop; Nana Wiberg; Anastasia Katsarou; Nael Shaat; Lars Kristensen; Kerstin Berntorp Journal: Diabetologia Date: 2019-03-23 Impact factor: 10.122
Authors: Maiju Kekki; Kati Tihtonen; Anne Salonen; Topias Koukkula; Mika Gissler; Hannele Laivuori; Tuomas T Huttunen Journal: Int J Gynaecol Obstet Date: 2022-01-07 Impact factor: 4.447
Authors: Anna L Secher; Lene Ringholm; Henrik U Andersen; Peter Damm; Elisabeth R Mathiesen Journal: Diabetes Care Date: 2013-01-24 Impact factor: 19.112