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

[Display omitted] • GDM increases infant fat mass accretion (1–6 months) despite excessive fetal growth. • SGA newborns have increased fat mass accretion from 1 to 3 and 1 to 6 months of age. • GDM treatment goals should consider factors affecting fetal growth restriction. 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). Healthy pregnant women and their term babies from the OBESO cohort were studied (1 M−3 M, n = 122; 1 M−6 M, n = 90). Registered maternal data was: pregestational body-mass-index (preBMI), GDM (2hOGTT), medications, gestational weight gain. Macrosomia (>4000 g), 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 (1 M, 3 M, 6 M) and FM accretion computed (ΔkgFM from 1 M−3 M and 1 M−6 M). Exclusive breastfeeding (EBF) was assessed. Adjusted-multiple linear regression models were performed. PreBMI was 27.4 ± 5.2 kg/m2. GDM was present in 9%(n = 11) of women; 12.3%(n = 15) of them received metformin/insulin. One newborn was LGA; 20.7%(n = 25) were SGA. From 1 M−3 M, SGA was a predictor of higher FM accretion (B:0.28, 95%CI:0.14–0.43); GDM was not associated. From 1 M−6 M, 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 (R2 ≥ 0.48, p < 0.001), infant weight and being female were positively associated, while maternal obesity, metformin/insulin, and EBF were not. GDM appears to program early higher adiposity accretion, independently of excessive fetal growth. SGA was associated with higher FM accretion in early infancy. [ABSTRACT FROM AUTHOR]