Aims: To characterise risk factors associated with having a small-for-gestational-age (SGA) infant in women being treated for gestational diabetes (GDM).
Methods: This was a retrospective observational cohort study of 308 women with GDM. Women were split into groups based on their infant’s size at delivery (SGA, appropriate-for-gestational-age (AGA), or large-for-gestational-age (LGA)). Literature review and expert opinion helped to determine several predictors of women with GDM delivering an SGA infant and statistical analysis was used to produce odds ratios (OR) for these predictors.
Results: The sample included primiparous women with a mean pre-pregnancy body mass index (BMI) of 25.72 (SD 5.75). Metabolic risk factors associated with delivering an SGA infant included a lower pre-pregnancy BMI (adjusted OR 1.13, p=0.04, 95% CI 1.01 to 1.26), a lower fasting blood glucose level (BGL) (adjusted OR 3.21, p=0.01, 95% CI 1.30 to 7.93) and growth that was high risk for SGA at baseline ultrasound (US) scan (adjusted OR 7.43, p<0.001, 95% CI 2.93 to 18.79).
Conclusions: Lower pre-pregnancy BMI, fasting BGL and baseline US growth measurements may indicate a need for less aggressive glucose management in women with GDM to prevent SGA infants.