Asymmetric large for gestational age newborns in pregnancies complicated by diabetes mellitus: is maternal obesity a culprit?

J Matern Fetal Neonatal Med. 2012 Jan;25(1):32-5. doi: 10.3109/14767058.2012.626925.


Objective: Evaluate the association between body mass index (BMI) and the delivery of an asymmetrically large for gestational age (A-LGA) newborn in women with diabetes.

Methods: Retrospective analysis of 306 pregnancies complicated by Type 1 and 55 by Type 2 diabetes.

Results: The prevalence of Type 1 and Type 2 diabetics delivering large for gestational age (LGA) infants was 42% and 49%, respectively. Of these 49% and 55% were A-LGA, respectively. Pre-pregnancy BMI was not associated with increased odds of delivering an A-LGA newborn in women with Type 1 or 2 diabetes. However, in Type 1 diabetics, each one-pound increase in maternal weight during pregnancy resulted in 4% increased odds of delivering an A-LGA newborn. For Type 2 diabetics, the odds of delivering an A-LGA infant was decreased by 10% for each 0.1 unit/kg increase in insulin dose.

Conclusion: Although there is a known association between obesity and LGA in women with diabetes, we found that overweight and obese women with Type 1 or Type 2 diabetes do not have increased odds of delivering an A-LGA newborn. However, insulin dose in Type 2 diabetes and maternal weight gain in Type 1 diabetes were significantly associated with the odds of delivering an A-LGA neonate.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Birth Weight
  • Body Mass Index
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 2 / complications*
  • Female
  • Fetal Macrosomia / epidemiology*
  • Fetal Macrosomia / etiology
  • Humans
  • Infant, Newborn
  • Insulin / administration & dosage
  • Obesity / complications*
  • Pregnancy
  • Pregnancy Complications*
  • Pregnancy in Diabetics*
  • Weight Gain


  • Insulin