학술논문

Risk of fetal undergrowth in the management of gestational diabetes mellitus in Japan
Document Type
article
Source
Journal of Diabetes Investigation, Vol 14, Iss 4, Pp 614-622 (2023)
Subject
Gestational diabetes
Large‐for‐gestational age
Low birth weight
Diseases of the endocrine glands. Clinical endocrinology
RC648-665
Language
English
ISSN
2040-1124
2040-1116
Abstract
Abstract Aims/Introduction In Japan, the increasing frequency of underweight among women of reproductive age and the accompanying increase in the rate of low birth weight (LBW) are social issues. The study aimed to establish a prospective registry system for gestational diabetes mellitus (GDM) in Japan and to clarify the actual status of GDM according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Materials and Methods Pregnant women with gestational diabetes mellitus and those in the normal glucose tolerance (NGT) group were enrolled in the Diabetes and Pregnancy Outcome for Mother and Baby study from October 2015. Pregnant women with positive glucose screening in early and mid‐to‐late pregnancy underwent a 75 g oral glucose tolerance test by gestational week 32. Gestational diabetes mellitus was diagnosed according to IADPSG criteria. Women with a positive glucose screening test at mid‐to‐late pregnancy but NGT were enrolled as references (NGT group). Treatment for gestational diabetes mellitus and maternal and neonatal pregnancy data were prospectively collected on outcomes. Results In total 1,795 singleton pregnancies (878 women with GDM and 824 NGT women) were analyzed. The risk of LBW and small‐for‐gestational age in the GDM group was significantly higher than in the NGT group. A similar relationship was found for LBW risk in the non‐overweight/obese group but not in the overweight/obese group. Conclusions We established a prospective GDM registry system in Japan. In the management of GDM in Japan, suppression of maternal weight gain may be associated with reduced fetal growth, especially in non‐overweight/obese women with GDM; however, further investigation is required.