Gestational diabetes mellitus and size at birth modify early adiposity accretion. Evidence from the OBESO cohort

Aim To evaluate the association between maternal obesity, gestational diabetes (GDM), and birth size with infant fat-mass (FM) accretion from 1 to 6 months (M). Methods Healthy pregnant women and their term babies from the OBESO cohort were studied (1M-3M, n=122; 1M-6M, n=90). Registered maternal data was: pregestational body-mass-index (preBMI), GDM (2hOGTT), medications, gestational weight gain. Macrosomia (>4000g), large/small for gestational age (LGA/SGA)(weight/age>90° and <90°, respectively-WHO) were recorded at birth. Infant FM (air-displacement plethysmography) was measured (1M, 3M, 6M) and FM accretion computed (ΔkgFM from 1M-3M and 1M-6M). Exclusive breastfeeding (EBF) was assessed. Adjusted-multiple linear regression models were performed. Results PreBMI was 27.4±5.2kg/m 2 . GDM was present in9%(n=11) of women; 12.3%(n=15) of them received metformin/insulin. One newborn was LGA; 20.7%(n=25) were SGA. From 1M-3M, SGA was a predictor of higher FM accretion (B:0.28, 95%CI:0.14-0.43); GDM was not associated. From 1M-6M, higher FM accretion was observed in SGA newborns (B:0.43, 95%CI:0.19-0.67) and GDM infants (B:0.48, 95%CI:0.06-0.89). In all models (R 2 ≥0.48, p<0.001), infant weight and being female were positively associated, while maternal obesity, metformin/insulin, and EBF were not. Conclusions GDM appears to program early higher adiposity accretion, independently of excessive fetal growth. SGA was associated with higher FM accretion in early infancy.