- Delivery of a macrosomic or large for gestational age (LGA) neonate in a previous nondiabetic pregnancy is associated with higher rates of gestational diabetes mellitus (GDM) in subsequent pregnancy.
Why this matters
- The Royal College of Obstetricians and Gynecologists recommends GDM testing if prior infant weighed ≥4500 g, but not for lower cutoffs or LGA.
- Case-control study of 47,823 women with singleton pregnancy and 2 consecutive deliveries without GDM or pregestational diabetes at prior pregnancy, of whom 2.7% (n=1312) had GDM in subsequent pregnancy and 97.3% did not.
- Funding: None.
- Dose-dependent positive association seen between previous pregnancy birthweight and GDM in subsequent pregnancy, from 1.8% for 3821 g.
- In multivariate analysis controlling for confounders including maternal age, parity, and BMI, independent predictors of GDM in subsequent pregnancy were (aOR):
- LGA (>90%) history: 1.7 (P=.0);
- Prior infant with birthweight ≥4000 g: 1.9 (P=.02); and
- Macrosomic infant ≥4500 g: 6.0 (P<.01>
- Women with previous infant weighing >4000 g had higher incidence in next pregnancy of:
- LGA infant: 49.8% vs 12.7% (P<.01>
- Infants weighing >4000 g: 29.9% vs 4.7% (P<.01>
- Infants weighing >4500 g: 4.5% vs 0.3% (P<.01>
- Cesarean delivery: 27.4% vs 19.6% (P<.01>
- Retrospective design.
- Single-center study.