Abnormal fetal growth is associated with gestational diabetes mellitus later in life: population-based register study.

Background: Increasing evidence has been collected that intrauterine growth restriction is associated with development of type-2 diabetes mellitus in adult life. The present study was designed to test the hypothesis that abnormal intrauterine growth of female fetuses correlates with their future risk of developing gestational diabetes mellitus (GDM).

Methods: Population-based register study of the data from the Swedish Medical Birth Registry; perinatal data from 1973 to 1983 were linked with the diagnosis of GDM during 1987-2001. 421 women with GDM diagnosis were compared to 60,890 controls with regard to maternal age and parity, maternal education (data from the Education Register of Statistics Sweden), maternal diagnosis of diabetes, gestational duration, birth weight, and gestational age-related birth weight.

Results: There was a significant association between low (odds ratio (OR): 2.15, 95% confidence interval (CI): 1.29-3.50), as well as high (OR: 1.97, 95% CI: 1.12-3.45) birth weight and later development of GDM. There was a U-shaped relation between the gestational age-related birth weight and risk of developing GDM. A young mother and prematurity increased the risk of the offspring developing GDM. Nine of the 421 women (2.1%) with GDM were born to mothers who had a diagnosis of diabetes. The corresponding figures for the controls were 205 of 60,890 (0.3%).

Conclusion: Intrauterine conditions and/or genetic disposition, which affect prenatal growth, increase the future risk of the female fetus developing GDM.