Birth weight

Abstract: Background It is controversial whether maternal hyperglycemia less severe than that in diabetes mellitus is associated with increased risks of adverse pregnancy outcomes Methods A total of 25,505 pregnant women at 15 centers in nine countries underwent 75-g oral glucose-tolerance testing at 24 to 32 weeks of gestation Data remained blinded if the fasting plasma glucose level was 105 mg per deciliter (58 mmol per liter) or less and the 2-hour plasma glucose level was 200 mg per deciliter (111 mmol per liter) or less Primary outcomes were birth weight above the 90th percentile for gestational age, primary cesarean delivery, clinically diagnosed neonatal hypoglycemia, and cord-blood serum C-peptide level above the 90th percentile Secondary outcomes were delivery before 37 weeks of gestation, shoulder dystocia or birth injury, need for intensive neonatal care, hyperbilirubinemia, and preeclampsia Results For the 23,316 participants with blinded data, we calculated adjusted odds ratios for adverse pregnancy outcomes associated with an increase in the fasting plasma glucose level of 1 SD (69 mg per deciliter [04 mmol per liter]), an increase in the 1-hour plasma glucose level of 1 SD (309 mg per deciliter [17 mmol per liter]), and an increase in the 2-hour plasma glucose level of 1 SD (235 mg per deciliter [13 mmol per liter]) For birth weight above the 90th percentile, the odds ratios were 138 (95% confidence interval [CI], 132 to 144), 146 (139 to 153), and 138 (132 to 144), respectively; for cord-blood serum C-peptide level above the 90th percentile, 155 (95% CI, 147 to 164), 146 (138 to 154), and 137 (130 to 144); for primary cesarean delivery, 111 (95% CI, 106 to 115), 110 (106 to 115), and 108 (103 to 112); and for neonatal hypoglycemia, 108 (95% CI, 098 to 119), 113 (103 to 126), and 110 (100 to 112) There were no obvious thresholds at which risks increased Significant associations were also observed for secondary outcomes, although these tended to be weaker Conclusions Our results indicate strong, continuous associations of maternal glucose levels below those diagnostic of diabetes with increased birth weight and increased cord-blood serum C-peptide levels

Abstract: Obesity is a serious international health problem that increases the risk of several common diseases. The genetic factors predisposing to obesity are poorly understood. A genome-wide search for type 2 diabetes-susceptibility genes identified a common variant in the FTO (fat mass and obesity associated) gene that predisposes to diabetes through an effect on body mass index (BMI). An additive association of the variant with BMI was replicated in 13 cohorts with 38,759 participants. The 16% of adults who are homozygous for the risk allele weighed about 3 kilograms more and had 1.67-fold increased odds of obesity when compared with those not inheriting a risk allele. This association was observed from age 7 years upward and reflects a specific increase in fat mass.