Skip to main content

ORIGINAL RESEARCH article

Front. Endocrinol.
Sec. Clinical Diabetes
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1474694
This article is part of the Research Topic Recent Advances in Gestational Diabetes: Diagnosis, Treatment and Prevention View all 3 articles

Gestational diabetes mellitus in previous pregnancy associated with the risk of large for gestational age and macrosomia in the second pregnancy

Provisionally accepted
Ying Wang Ying Wang 1,2,3Juan Yang Juan Yang 1,2,3Yuzhen Liu Yuzhen Liu 1,2,3Ao Yang Ao Yang 1,2,3Yuqing Deng Yuqing Deng 1,2,3Chang Xu Chang Xu 4Shilin Zhong Shilin Zhong 1,2,3*
  • 1 Center of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, China
  • 2 Institute of Obstetrics and Gynecology, Shenzhen PKU-HKUST Medical Center, Shenzhen, China
  • 3 Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecologic Diseases, Shenzhen, China
  • 4 Intelligent Hospital Research Academy, Peking University Shenzhen Hospital, Shenzhen, China

The final, formatted version of the article will be published soon.

    Background: Since the implementation of China's new birth policy, the incidence of large for gestational age (LGA) and macrosomia associated with gestational diabetes mellitus (GDM) has increased. It remains unclear whether a history of GDM in a previous pregnancy raises the risk ofLGA or macrosomia in Chinese women planning two or more pregnancies.To analyze the association between previous GDM and the risk of LGA and macrosomia in second pregnancy.Method: A retrospective study was conducted on a cohort of 3,131 women who had experienced two consecutive singleton births. The incidences of LGA and macrosomia in the second pregnancy were compared between women with and without previous GDM. The relationship between previous GDM and the occurrence of LGA and macrosomia was analyzed using multivariate logistic regression and stratified analysis.The incidence of LGA and macrosomia during the second pregnancy was significantly higher in women with previous GDM (22.67% and 10.25%, respectively) compared to those without prior GDM (15.34% and 5.06%, respectively) (P < 0.05). After adjusting for potential confounders, previous GDM was significantly associated with LGA (aOR: 1.511, 95% CI: 1.066-2.143) and macrosomia (aOR: 1.854, 95% CI: 1.118-3.076) in the second pregnancy. Stratified analysis revealed 2 that these associations were present only in women without previous LGA, those with GDM, appropriate gestational weight gain (AGWG), non-advanced maternal age, and male newborns during the second pregnancy (P < 0.05). Compared to excessive GWG (EGWG), AGWG correlated with lower risks for LGA and macrosomia during the second pregnancy in women without prior GDM, an association not observed in those with previous GDM. Among women without previous GDM, if the pre-pregnancy BMI is normal, the risk of LGA and macrosomia is significant lower in AGWG compared with EGWG (P< 0.001), while this difference was no significant among women with prior GDM (P＞0.05).Previous GDM is strongly linked to LGA and macrosomia in subsequent pregnancies.However, this relationship is influenced by GWG, prior LGA history, fetal sex, and maternal age.Managing weight alone may not sufficiently reduce the risk of LGA or macrosomia for women with a history of GDM.

    Keywords: large for gestational age, Macrosomia, gestational diabetes mellitus, Body Mass Index, gestational weight gain, Multipara

    Received: 02 Aug 2024; Accepted: 13 Jan 2025.

    Copyright: © 2025 Wang, Yang, Liu, Yang, Deng, Xu and Zhong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Shilin Zhong, Center of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.