Maternal overweight is not an independent risk factor for increased birth weight, leptin and insulin in newborns of gestational diabetic women: observations from the prospective ‘EaCH’ cohort study

Ott, Raffael; Stupin, Jens H.; Loui, Andrea; Eilers, Elisabeth; Melchior, Kerstin; Rancourt, Rebecca C.; Schellong, Karen; Ziska, Thomas; Dudenhausen, Joachim W.; Henrich, Wolfgang; Plagemann, Andreas

doi:10.1186/s12884-018-1889-8

Table 1 General and specific cohort characteristics

From: Maternal overweight is not an independent risk factor for increased birth weight, leptin and insulin in newborns of gestational diabetic women: observations from the prospective ‘EaCH’ cohort study

Characteristics	Total GDM cohort		Maternal prepregnancy BMI category
Characteristics	Total GDM cohort		Normal weight	Overweight	Obese	P-value^a
	N
n		205	89^b	51^b	65^b
Paternal
Age (years)	204	35.7 ± 7.7	35.9 ± 7.2	36.2 ± 7.6	34.9 ± 8.4	ns
Socio-economic status – %^c
Lower SES category	143	69.8	54.5	68.0	93.8^d	< 0.001
Higher SES category	60	29.3	45.5	32.0	6.2^d	< 0.001
BMI (kg/m²)	202	26.9 ± 5.0	25.5 ± 3.2	27.0 ± 4.7^d	28.7 ± 6.4^d	0.002
Maternal
Age (years)	205	31.8 ± 5.4	32.2 ± 5.5	31.2 ± 4.9	31.7 ± 5.8	ns
Ethnic origin – %
European	129	62.9	73.0	52.9^d	56.9^d	< 0.001
Non-European (e.g. Turkish, Arabic)	76	37.1	27.0	47.1^d	43.1^d	< 0.001
Socio-economic status – %^c
Lower SES category	161	78.5	62.9	86.3^d	93.8^d	< 0.001
Higher SES category	44	21.1	37.1	13.7^d	6.2^d	< 0.001
Smoking in pregnancy (any) – %	30	14.6	10.1	7.8	26.2^d	0.009
Nulliparous – %	61	29.8	37.1	37.3	13.9^d	0.002
History of GDM (multiparous only) – %	52	40.6	29.2	48.4	46.9	ns
Height (cm)	205	165.8 ± 6.6	166.9 ± 6.6	164.9 ± 7.0	165.1 ± 6.2	ns
Prepregnancy weight (kg)	205	76.8 ± 20.9	60.6 ± 6.7	73.8 ± 6.6^d	101.4 ± 17.6^d	< 0.001
Prepregnancy BMI (kg/m²)	205	28.0 ± 7.4	21.7 ± 1.7	27.1 ± 1.4^d	37.1 ± 5.5^d	< 0.001
Total GWG (kg)	205	13.4 ± 6.4	14.8 ± 5.3	14.0 ± 7.1	10.8 ± 6.4^d	< 0.001
GWG category (IOM) – %
Inadequate	43	21.0	28.1	19.6	12.3^d	ns
Adequate	67	32.7	37.1	23.5	33.9	ns
Excessive	95	46.3	34.8	56.9^d	53.8^d	0.014
Net GWG (kg)	205	9.3 ± 6.3	11.0 ± 5.2	9.7 ± 7.0	6.6 ± 6.3^d	< 0.001
BMI at delivery (kg/m²)	205	32.8 ± 7.1	27.1 ± 2.5	32.3 ± 2.7^d	41.1 ± 5.5^d	< 0.001
Blood glucose at oGTT (mg/dL)^e
Fasting	205	94.2 ± 19.0	88.6 ± 13.3	91.8 ± 14.3	103.7 ± 24.7^d	< 0.001
Fasting > 90 mg/dL – %^f	118	57.6	42.7	54.9	80.0^d	< 0.001
1 h	203	197.0 ± 28.2	196.0 ± 26.0	192.8 ± 24.0	201.8 ± 33.4	ns
1 h > 180 mg/dL – %^f	169	83.7	86.5	80.0	82.5	ns
2 h	193	144.5 ± 37.6	140.0 ± 27.3	143.3 ± 32.4	151.4 ± 50.6	ns
2 h > 155 mg/dL – %^f	63	32.8	28.6	34.0	37.7	ns
Area under the curve (mg/dL*h)	193	315.6 ± 44.3	310.2 ± 32.9	306.9 ± 31.0	329.6 ± 60.6	ns
Mean glucose at 32nd weeks’ gestation (mg/dL)^g
Fasting	195	88.0 ± 11.3	83.8 ± 7.0	87.8 ± 9.0^d	93.8 ± 14.5^d	< 0.001
Fasting > 90 mg/dL – %^f	70	35.9	16.9	34.7^d	61.9^d	< 0.001
Postprandial	183	121.7 ± 14.3	117.6 ± 11.5	122.8 ± 13.3^d	126.4 ± 16.8^d	< 0.001
Postprandial > 140 mg/dL – %^f	14	7.7	2.5	6.8	15.0^d	0.020
Mean glucose at 36th weeks’ gestation (mg/dL)^g
Fasting	188	84.2 ± 8.0	80.8 ± 6.0	85.2 ± 8.0^d	87.7 ± 8.4^d	< 0.001
Fasting > 90 mg/dL – %^f	38	20.2	6.3	20.0^d	37.5^d	< 0.001
Postprandial	169	118.6 ± 12.1	114.0 ± 8.9	121.5 ± 14.0^d	122.3 ± 12.2^d	ns
Postprandial > 140 mg/dL – %^f	6	3.6	0.0	4.8	7.1^d	ns
HbA1c in 3rd trimester (%)	196	5.4 ± 0.6	5.1 ± 0.4	5.5 ± 0.6^d	5.7 ± 0.6^d	< 0.001
HbA1c in 3rd trimester > 6% – %	24	12.2	2.4	18.8^d	20.3^d	< 0.001
HbA1c partum (%)	197	5.5 ± 0.6	5.3 ± 0.5	5.6 ± 0.5^d	5.8 ± 0.6^d	< 0.001
HbA1c partum > 6% – %	42	21.3	6.9	23.9^d	39.1^d	< 0.001
Insulin therapy – %	75	36.6	16.9	41.2^d	60.0^d	< 0.001
Prepregnancy hypertension – %	10	4.9	2.2	2.0	10.8^d	0.035
Gestational hypertension – %	12	5.9	2.2	5.9	10.8^d	ns
Preeclampsia – %	9	4.4	2.2	2.0	9.2	ns
Mode of delivery – %
Spontaneous	115	56.1	66.3	45.1^d	50.8	0.028
Vaginal-operative	20	9.8	7.9	17.7	6.2	ns
Primary Cesarean section	31	15.1	15.7	11.8	16.9	ns
Repeat Cesarean section	39	19.0	10.1	25.5^d	26.2^d	0.015
Gestational age at delivery (weeks)	205	38.6 ± 1.5	38.7 ± 1.6	38.9 ± 1.3	38.3 ± 1.5^d	ns
Newborn
Female sex – %	88	42.9	43.8	43.1	41.5	ns
Preterm birth (< 37 weeks’ gestation) – %	15	7.3	6.7	3.9	10.8	ns
Placental weight (g)	201	607.0 ± 159.9	559.4 ± 124.6	666.1 ± 172.3^d	624.9 ± 175.1^d	< 0.001
Birth weight (g)	205	3450 ± 506	3345 ± 496	3591 ± 481^d	3483 ± 514	0.006
Birth length (cm)	205	51.3 ± 2.5	51.2 ± 2.5	51.7 ± 2.4	50.9 ± 2.5	ns
Relative birth weight (g/cm)	205	67.1 ± 8.1	65.1 ± 7.8	69.3 ± 7.7^d	68.2 ± 8.4^d	0.001
Ponderal index (g/cm³ × 100)	205	2.6 ± 0.3	2.5 ± 0.2	2.6 ± 0.3	2.6 ± 0.3^d	0.009
Birth weight category – %
SGA	9	4.4	4.5	2.0	6.2	ns
AGA	155	75.6	84.3	70.6	67.7^d	0.036
LGA	41	20.0	11.2	27.5^d	26.2^d	0.018
Macrosomia (≥4000 g) – %	27	13.2	7.9	21.6^d	13.8	ns
Head circumference (cm)	205	34.8 ± 2.9	34.7 ± 1.8	35.3 ± 1.4	35.0 ± 1.5	ns
Hypoglycemia – %	20	9.8	5.6	7.8	16.9^d	ns
Shoulder dystocia – %	1	0.5	0.0	0.0	1.5	ns
Cord-blood plasma levels
C-peptide (ng/mL)	162	1.4 ± 0.7	1.3 ± 0.6	1.4 ± 0.7	1.6 ± 0.7^d	0.016
C-peptide > 90th percentile – %^h	17	10.5	5.4	7.7	20.4^d	0.034
Insulin (μU/mL)	164	17.3 ± 13.7	14.3 ± 10.6	18.5 ± 17.6	20.7 ± 13.6^d	0.022
Insulin > 90th percentile – %^h	15	9.2	5.4	7.9	15.7	ns
Leptin (ng/mL)	164	13.3 ± 10.7	10.6 ± 8.6	15.2 ± 11.1^d	15.9 ± 12.3^d	0.013
Leptin > 90th percentile – %^h	16	9.8	6.8	10.3	13.7	ns

Data are shown as mean ± SD or %. N: Number of subjects with characteristic. n: Total number of subjects
Abbreviations: GDM Gestational diabetes mellitus, BMI Body-mass-index, ns Non-significant, SES Socio-economic status, GWG Gestational weight gain, IOM Institute of Medicine, oGTT Oral glucose tolerance test, HbA1c Glycated hemoglobin A1c, SGA Small-for-gestational age, AGA Appropriate-for-gestational age, LGA Large-for-gestational age
^aStatistical significant differences (P < 0.05) across all pregestational BMI groups were assessed using one-way ANOVA with Tukey’s post hoc test or Kruskal-Wallis test with Dunn’s post hoc test and Fisher’s exact or Chi-squared tests, as appropriate. ^bn across variables: Normal weight = 74–89, overweight = 39–51, obese = 49–65. ^cLower (unemployed, manual and non-manual worker without university degree) or higher SES (non-manual worker with university degree) [23, 24]. ^dStatistical significant difference vs. normal weight. ^eoGTT at 25.6 ± 3.8 weeks’ gestation. ^fBlood glucose values above guideline cut-offs at the time of study [27]. ^gMean fasting and 1-h postprandial glucose values were calculated using self-monitored blood glucose data from three days at respective weeks’ gestation. ^hStudy 90th percentile cut-offs: C-Peptide 2.2 ng/mL, Insulin 34.2 μU/mL, Leptin 29.6 ng/mL.

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