Maternal Diabetes may Increase Infection Risk in Early Infancy: Study
Renovation Work Shuts 10 Public Maternity Hospitals in Bengaluru
A study from Johns Hopkins University published in Diabetes Care has revealed that babies born to mothers with gestational or pregestational diabetes have a higher risk of infections during the first six months of life. Pregestational diabetes was specifically associated with reduced immunoglobulin G (IgG) diversity in newborns, with the effect more pronounced in infants born preterm or via cesarean delivery. The study was published in the journal Diabetes Care by Guoying Wang and fellow researchers.
Pregnancies complicated by maternal diabetes have been known for many years to be associated with adverse perinatal outcomes, but the effects of diabetes in pregnancy on early life immunity are currently poorly characterized. The aim of the study was to investigate whether diabetes in pregnancy, gestational diabetes mellitus (GDM) or pregestational diabetes mellitus (PDM), is associated with alterations in the neonatal global IgG repertoire and an increased risk of infection in early life.
This was a prospective longitudinal cohort study of 2,702 mother-infant pairs enrolled at birth and followed up at Boston Medical Center. Maternal diabetes status and infant infections were ascertained from electronic medical records. Cord blood was analyzed for IgG antibody profiles against a broad range of microbial antigens using Phage ImmunoPrecipitation Sequencing. Infant infections were evaluated in the neonatal period and during the first 6 months of life.
Key findings
Within the cohort, 327 infants (12.1%) were exposed to maternal gestational diabetes, and 138 infants (5.1%) were exposed to maternal pregestational diabetes.
In total, 416 infants (15.4%) had at least one infection during the neonatal period, and 1,425 infants (52.7%) had at least one infection during the first 6 months of life.
Infants exposed to maternal diabetes had a significantly increased risk of infection during the first 6 months of life compared with those not exposed to maternal diabetes.
Maternal gestational diabetes was linked to a 20% increased risk of infant infections (risk ratio [RR] 1.20, 95% CI 1.09-1.32), while pregestational diabetes was linked to a 28% increased risk (RR 1.28, 95% CI 1.12-1.47).
These associations were greatest for preterm infants, those delivered by cesarean section, or those with lower IgG repertoire diversity.
Infants born to mothers with pregestational diabetes had a lower global IgG repertoire diversity at birth compared with infants born to mothers without diabetes. This effect was even more pronounced when mothers were overweight or obese. A lower IgG diversity seemed to accentuate the relationship between maternal diabetes and infant infection risk, implying a mechanistic relationship between impaired passive immunity and infections.
Maternal diabetes during pregnancy was found to be associated with an increased risk of infection in infants and a reduced diversity of the neonatal IgG repertoire, especially in the presence of pregestational diabetes. A reduced IgG diversity index further reinforced the link between diabetes and infection.
Reference:
Guoying Wang, Ingo Ruczinski, H. Benjamin Larman, Maria J. Gutierrez, Pamela A. Frischmeyer-Guerrerio, Xiumei Hong, Hongkai Ji, Colleen Pearson, William G. Adams, Xiaobin Wang; Impact of Maternal Diabetes in Pregnancy on Newborn IgG Antibody Repertoire and Infection Risk in the First Six Months of Life. Diabetes Care 2026; dc250990. https://doi.org/10.2337/dc25-0990
