• Wen Yang, Jin Liu, Jing Li, Jinnan Liu, Hongyan Liu, Yue Wang, Junhong Leng, WangShuoSProject Office, Tianjin Women and Children's Health Center, Tianjin, China., Huaxi Chen, ChanJuliana C NJCNDepartment of Medicine and Therapeutics, Hong Kong Institute of Diabetes and Obesity and The Chinese University of Hong Kong-Prince of Wales Hospital-International Diabetes Federation Centre of Education, The Chinese University of Hong K, Zhijie Yu, Gang Hu, and Xilin Yang.
• Department of Epidemiology and Biostatistics, School of Public Health, and Tianjin Key Laboratory of Environment, Nutrition & Public Health, Tianjin Medical University, Tianjin, China.
• Diabetes Res. Clin. Pract. 2019 Aug 1; 154: 82-89.

AimsObesity increases risk of gestational diabetes mellitus (GDM) and GDM increases risk of macrosomia but their inter-relations for increased risk of macrosomia remain uncertain. We aimed to examine associations between prepregnancy overweight and macrosomia, and synergistic effects between prepregnancy overweight and GDM on macrosomia.MethodsFrom 2010 to 2012, 19,622 women in urban Tianjin, China, underwent a 50-g 1-h glucose challenge test (GCT) at 24-28 gestational weeks and followed by a 75-g 2-h oral glucose tolerance test (OGTT) if the GCT value was ≥ 7.8 mmol/L. GDM was defined according to International Association of Diabetes and Pregnancy Study Group's criteria. Overweight was defined as body mass index ≥ 24.0 kg/m2. Logistic regression was performed to obtain odds ratios (ORs) and 95% confidence intervals (CIs). Additive interaction between prepregnancy overweight and GDM was used to test synergistic effects.ResultsIn the cohort, 1791 (9.1%) and 1726 (8.8%) of the women delivered a macrosomic infant or a large-for-gestational-age (LGA) infant, respectively. Prepregnancy overweight was associated with increased risk of macrosomia and LGA with adjusted ORs being 2.29 (95%CI: 2.07-2.54) and 2.27 (2.05-2.52), respectively. Copresence of prepregnancy overweight and GDM greatly enhanced the adjusted ORs of overweight alone (ORs for macrosomia and LGA: 2.17, 1.94-2.42 & 2.21,1.98-2.47) and GDM alone (ORs for macrosomia and LGA: 2.01,1.48-2.72 & 2.14, 1.60-2.87) for macrosomia and LGA to 5.29 (4.07-6.87) for macrosomia and 4.72 (3.66-6.10) for LGA, with significant additive interactions.ConclusionsPrepregnancy overweight increased the risks of macrosomia and LGA independently and synergistically with GDM.Copyright © 2019 Elsevier B.V. All rights reserved.

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