RESEARCH REPORTS

Maternal glucose tolerance status influences the risk of macrosomia in male but not in female fetuses

W Ricart¹, J López², J Mozas³, A Pericot⁴, M A Sancho⁵, N González⁶, M Balsells⁷, R Luna⁸, A Cortázar⁹, P Navarro¹⁰, O Ramírez¹¹, B Flández¹², L F Pallardo¹³, A Hernández¹⁴, J Ampudia¹⁵, J M Fernández-Real¹, I Hernández-Aguado¹⁶, R Corcoy¹⁷, for the Spanish Group for the study of the impact of Carpenter and Coustan GDM thresholds

¹ Hospital Universitari de Girona Doctor Josep Trueta, Girona, IdlBGi. CIBER Fisiopatologia de la Obesidad y Nutrició
² Hospital Virgen de la Salud, Toledo
³ Hospital Universitario Virgen de las Nieves, Granada
⁴ Hospital Clínic Universitari de Barcelona, Barcelona
⁵ Hospital Clínico Universitario Lozano Blesa, Zaragoza
⁶ Hospital Universitario de Canarias, Tenerife
⁷ Hospital Mutua de Terrassa, Terrassa
⁸ Complejo Hospitalario Universitario Xeral-Cíes de Vigo, Vigo
⁹ Hospital de Cruces, Barakaldo
¹⁰ Hospital General Universitario, Alicante
¹¹ Hospital Universitario Materno-Infantil de Canarias, Las Palmas de Gran Canaria
¹² Hospital Universitario de Getafe, Getafe
¹³ Hospital La Paz, Madrid
¹⁴ Hospital Universitario Dr Peset, Valencia
¹⁵ Hospital Clínico de Valencia, Valencia
¹⁶ Hospital Universitario de Alicante, CIBER Epidemiologia y Salud Pública
¹⁷ Hospital de Sant Pau, Barcelona, CIBER Bioingenieria, Biomateriales y Nanotecnologia

Dr. W Ricart, Unit of Diabetes, Endocrinology and Nutrition, Hospital Universitari de Girona Dr Josep Trueta, Avgda de França s.n., 17007-Girona, Spain; uden.wricart{at}htrueta.scs.es

Objective: To elucidate whether the risk of macrosomia, large for gestational age (LGA) and small for gestational age (SGA) is influenced by maternal body mass index and glucose tolerance differently in male and female fetuses.

Methods: A population study was conducted in 16 general hospitals from the Spanish National Health Service that included 9270 consecutive women with singleton pregnancies and without a former diagnosis of diabetes mellitus who delivered 4793 male and 4477 female newborns. Logistic regression analyses were performed to predict the effect of body mass index (BMI) category and glucose tolerance on macrosomia, large for gestational age newborns (LGA) and small for gestational age newborns (SGA) Separate analyses according to foetal sex were carried out for each outcome. The results were adjusted for maternal age, gestational age and pregnancy-induced hypertension.

Results: There were significant differences between males and females in the percentage of infants who had macrosomia, LGA or SGA. Maternal BMI category was positively associated with the risk of macrosomia and LGA in both male and female newborns. In addition, there was a negative association between maternal BMI and SGA that only reached significance in males. In contrast, gestational diabetes was only a predictor of macrosomia exclusively in male fetuses (OR 1.67, 95% CI 1.12 to 2.49)

Conclusions: There is sexual dimorphism in the risk of abnormal birth weight attributed to maternal glucose tolerance status. A closer surveillance of foetal growth might be warranted in pregnant women with abnormal glucose tolerance carrying a male fetus.

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