Type 2 Diabetes in Pregnancy Linked to Higher Risk of Delivering Large-for-Gestational-Age Infants: Study
China: Pregnant women with type 2 diabetes mellitus (T2DM) who deliver large-for-gestational-age (LGA) infants face significantly higher risks of adverse maternal and neonatal outcomes, a recent study published in BMC Pregnancy and Childbirth has shown.
The analysis revealed that such women are nearly twice as likely to experience postpartum hemorrhage. At the same time, their newborns are at greater risk of shoulder dystocia, hypoglycemia, and admission to the neonatal intensive care unit (NICU).
The study, led by Xin Yan and colleagues from the Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, aimed to explore the risk factors contributing to the delivery of LGA infants among women with T2DM and to assess the associated pregnancy outcomes.
Researchers retrospectively analyzed data from 691 pregnant women with T2DM who received prenatal care and delivered at the Beijing Obstetrics and Gynecology Hospital between January 2012 and December 2020.
The following were the key findings:
- Out of 691 pregnant women with type 2 diabetes mellitus, 257 (37.19%) delivered large-for-gestational-age (LGA) infants.
- Higher pre-pregnancy body mass index (BMI), multiparity, history of polycystic ovary syndrome (PCOS), elevated late-pregnancy HbA1c levels, greater gestational weight gain, and female fetal sex were identified as independent risk factors for LGA births.
- Multiparous women had more than twice the likelihood of delivering LGA infants (OR 2.4).
- Women with a history of PCOS had a 2.2-fold higher risk of delivering LGA infants.
- Each unit increase in pre-pregnancy BMI slightly raised the risk of LGA delivery (OR 1.05).
- Elevated late-pregnancy HbA1c levels more than doubled the likelihood of delivering LGA infants (OR 2.1).
- Delivering an LGA infant significantly increased the chances of postpartum hemorrhage (OR 1.8).
- The risk of shoulder dystocia was six times higher among mothers of LGA infants.
- Newborns of LGA deliveries were nearly twice as likely to experience hypoglycemia (OR 1.99).
- These newborns also had a 1.5-fold higher likelihood of requiring admission to the neonatal intensive care unit (NICU).
According to Yan and colleagues, these findings highlight the importance of early risk identification and targeted management strategies to prevent adverse outcomes in pregnant women with T2DM. The authors emphasized that maintaining optimal pre-pregnancy weight, ensuring appropriate weight gain during gestation, and achieving good glycemic control, particularly in late pregnancy, are crucial to reducing the incidence of LGA births and their complications.
The study, though robust in its multi-year dataset, had certain limitations. Being retrospective, it was susceptible to selection and information biases and could not establish causality. Moreover, as it was conducted at a single center, the findings may not be generalizable to broader populations. Lifestyle factors such as diet and physical activity were also not captured, potentially influencing the outcomes.
Despite these limitations, the research offers valuable insights into the interplay between metabolic health and pregnancy outcomes in women with type 2 diabetes. The authors concluded that effective preconception counseling, dietary guidance, and regular monitoring during pregnancy are vital to minimizing risks associated with LGA births and ensuring better maternal and neonatal health.
Reference:
Yan, X., Zhang, L., Zheng, W. et al. Risk factors and adverse pregnancy outcomes associated with large for gestational age infants in pregnant women with type 2 diabetes mellitus. BMC Pregnancy Childbirth 25, 950 (2025). https://doi.org/10.1186/s12884-025-08032-x
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