Higher carbohydrate intake is associated with decreased incidence of newborn macrosomia in women with gestational diabetes

J Am Diet Assoc. 2001 Aug;101(8):897-902. doi: 10.1016/S0002-8223(01)00220-6.


Objective: To study the influence of energy and macronutrient intake on infant birthweight in women with gestational diabetes mellitus undergoing intensive management.

Design: This prospective study evaluated the impact of intensive management of gestational diabetes on maternal and fetal morbidity, and addressed the relationship between food intake and infant birthweight.

Setting: Fifteen maternity hospitals in northern France.

Subjects: Ninety-nine women with gestational diabetes or gestational mild hyperglycemia diagnosed between 24 and 34 weeks of gestation were surveyed. After 1 was excluded because of a premature birth and 18 were excluded as underreporters, 80 women were included in the final analysis. Diet intake was assessed by a dietary history at the first interview, and by two 3-day diet records at the 3rd and 7th week after diagnosis.

Results: In a forward-stepwise regression analysis (controlling for maternal age; smoking; parity; prepregnancy BMI; pregnancy weight gain; gestational duration; infant sex; fasting and 2-hour postprandial serum glucose; insulin therapy; and energy, fat, protein and carbohydrate intake during treatment) infant birthweight was positively associated with gestational duration (beta = +0.34, P<.002), and negatively with smoking (beta = -0.27, P<.02) and carbohydrate intake (beta = -0.24, P<.03). There were no large-for-gestational-age infants among women whose carbohydrate intake exceeded 210 g/day.

Conclusion: For women with gestational diabetes undergoing intensive management, higher carbohydrate intake is associated with decreased incidence of macrosomia.

Application: These findings suggest that nutrition counseling in gestational diabetes must be directed to maintain a sufficient carbohydrate intake (at least 250 g per day), which implies a low-fat diet to limit energy intake. A careful distribution of carbohydrate throughout the day and the use of low-glycemic index foods may help limit postprandial hyperglycemia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Birth Weight
  • Blood Glucose / analysis
  • Diabetes, Gestational / blood
  • Diabetes, Gestational / complications*
  • Diabetes, Gestational / diet therapy*
  • Diabetes, Gestational / mortality
  • Diet Records
  • Diet Surveys
  • Diet, Diabetic*
  • Dietary Carbohydrates / administration & dosage*
  • Energy Intake
  • Female
  • Fetal Macrosomia / etiology*
  • Fetal Macrosomia / mortality
  • Fetal Macrosomia / prevention & control
  • Gestational Age
  • Humans
  • Hyperglycemia / diet therapy
  • Hyperglycemia / prevention & control
  • Incidence
  • Infant, Newborn
  • Nutritional Physiological Phenomena
  • Nutritional Requirements
  • Pregnancy
  • Pregnancy Complications / blood
  • Pregnancy Complications / diet therapy
  • Pregnancy Complications / mortality
  • Pregnancy Outcome
  • Pregnancy Trimester, Second
  • Prospective Studies
  • Regression Analysis


  • Blood Glucose
  • Dietary Carbohydrates