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No Metabolic Dysfunction for LGA Delivery Without GDM

No postpartum metabolic dysfunction for women without gestational diabetes delivering large babies

FRIDAY, Oct. 14 (HealthDay News) -- Women without gestational diabetes mellitus (GDM) who have a large-for-gestational-age (LGA) delivery (nonGDM-LGA) do not have postpartum metabolic dysfunction typically seen in women with GDM, according to a study published online Oct. 4 in Diabetes Care.

Simone Kew, from Mount Sinai Hospital in Toronto, and colleagues assessed metabolic function during and after pregnancy in 46 nonGDM-LGA women, 152 women with established GDM, and 364 women with neither GDM nor LGA delivery (nonGDM). All participants underwent metabolic characterization, including oral glucose tolerance test (OGTT) in late pregnancy and at three months postpartum.

The investigators found that postpartum glucose intolerance was predicted by GDM (odds ratio, 4.1), and not by nonGDM-LGA. Women in the GDM group had significantly higher mean adjusted levels of fasting glucose and area under the glucose curve on the OGTT at three months, and lower mean adjusted insulin sensitivity and β-cell function than those in the nonGDM or nonGDM-LGA group. There was no significant difference between the nonGDM and nonGDM-LGA group with respect to these results.

"An LGA delivery in the absence of GDM is not necessarily indicative of undiagnosed gestational glucose intolerance but, rather, may be due to the influence of other factors," the authors write. "These data suggest that the long-standing clinical assumption that delivery of an LGA infant reflects undiagnosed maternal hyperglycemia may no longer be appropriate in modern practice."

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