Gestational diabetes mellitus and infant adiposity at birth: A systematic review and meta-analysis of therapeutic interventions
Herath, M and Beckett, J and Hills, AP and Byrne, NM and Ahuja, KDK, Gestational diabetes mellitus and infant adiposity at birth: A systematic review and meta-analysis of therapeutic interventions, Journal of Clinical Medicine, 10, (4) pp. 1-26. ISSN 2077-0383 (2021) [Refereed Article]
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Exposure to untreated gestational diabetes mellitus (GDM) in utero increases the risk of
obesity and type 2 diabetes in adulthood, and increased adiposity in GDM-exposed infants is suggested as a plausible mediator of this increased risk of later-life metabolic disorders. Evidence is
equivocal regarding the impact of good glycaemic control in GDM mothers on infant adiposity at
birth. We systematically reviewed studies reporting fat mass (FM), percent fat mass (%FM) and
skinfold thicknesses (SFT) at birth in infants of mothers with GDM controlled with therapeutic interventions (IGDMtr). While treating GDM lowered FM in newborns compared to no treatment,
there was no difference in FM and SFT according to the type of treatment (insulin, metformin, glyburide). IGDMtr had higher overall adiposity (mean difference, 95% confidence interval) measured
with FM (68.46 g, 29.91 to 107.01) and %FM (1.98%, 0.54 to 3.42) but similar subcutaneous adiposity
measured with SFT, compared to infants exposed to normal glucose tolerance (INGT). This suggests
that IGDMtr may be characterised by excess fat accrual in internal adipose tissue. Given that intraabdominal adiposity is a major risk factor for metabolic disorders, future studies should distinguish
adipose tissue distribution of IGDMtr and INGT.