Neonatal adiposity is predominantly influenced by maternal hyperglycemia than obesity: Evidence from India.

Maternal type of diabetes was independently associated with larger neonatal size and adiposity, with a stronger influence than overweight-obesity.

• Study included 772 pregnancies with diabetes (61 type 1, 79 type 2, 632 GDM) and 349 with normal glucose tolerance (NGT).
• ANCOVA was used to examine associations with neonatal weight, abdominal circumference, and skinfold thickness.
• Both maternal diabetes and overweight-obesity were independently associated with larger neonatal size and adiposity, but diabetes had a stronger influence.
• Gestational weight gain (GWG) was not associated with neonatal outcomes.

Neonates of mothers with type 1 diabetes were the heaviest despite their mothers having the lowest BMI.

• Mothers with type 1 diabetes had the lowest BMI and highest HbA1c among diabetes groups.
• Compared to neonates of NGT mothers, neonates of type 1 diabetes mothers were 300 g heavier.
• Neonates of type 2 diabetes mothers were 174 g heavier than neonates of NGT mothers.
• Neonates of GDM mothers were 111 g heavier than neonates of NGT mothers.
• Similar patterns were observed for abdominal circumference and skinfold thickness.

Maternal overweight-obesity was associated with greater neonatal weight, but to a lesser degree than maternal diabetes.

• Neonates of overweight-obese mothers were 128 g heavier than those of non-overweight mothers.
• This effect (128 g) was smaller than the effect of type 1 diabetes (300 g), type 2 diabetes (174 g), and comparable to GDM (111 g) on neonatal weight.
• Maternal overweight-obesity was independently associated with larger neonatal size and adiposity after accounting for diabetes status.

The study population was a lean Indian cohort attending one diabetes clinic, providing evidence from a non-Western population.

• The study analyzed routine clinical data collected in one diabetes clinic in India.
• Total sample comprised 1,121 pregnancies (772 with diabetes, 349 with NGT).
• The population was described as 'lean Indian population,' indicating lower average BMI compared to Western populations.
• The findings suggest that in this lean population, hyperglycemia rather than adiposity is the predominant driver of neonatal adiposity.

Adequate control of maternal hyperglycemia is recommended as the primary intervention to reduce neonatal adiposity.

• Authors concluded that 'maternal glycaemia had a much stronger effect on neonatal adiposity compared to her overweight-obesity.'
• The paper states 'adequate control of maternal hyperglycemia will help control neonatal adiposity.'
• The gradient of neonatal weight increase corresponded to severity/type of maternal glycemic dysregulation (type 1 > type 2 > GDM > NGT).