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Peer-reviewedCC BYJournal of Diabetes Investigation

Underweight at age 20 and pre‐pregnancy and large‐for‐gestational‐age births in Japanese women with gestational diabetes mellitus: Hamamatsu GRACE Study 4

  • Shinya Furukawa1
  • Ayumi Kanamoto2
  • Yukino Toyama3
  • Kei Takeshita3
  • Takuya Hashimoto3
  • Teruki Miyake4
  • Daisuke Tsuriya3
4 affiliations
  1. 1Health Services Center Ehime University Ehime Japan
  2. 2Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine Ehime Japan
  3. 3Division of Endocrinology and Metabolism, Second Department of Internal Medicine Hamamatsu University School of Medicine Shizuoka Japan
  4. 4Department of Lifestyle‐Related Medicine and Endocrinology Ehime University Graduate School of Medicine Ehime Japan
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Abstract

Aims/Introduction While maternal obesity is a well‐established risk factor for large‐for‐gestational‐age (LGA) infants, the impact of maternal underweight on LGA in women with gestational diabetes mellitus (GDM) remains inconsistent. This issue is particularly relevant in Japan, given the high prevalence of underweight women. We investigated the association between maternal weight and body mass index (BMI) at age 20 and pre‐pregnancy and the risk of LGA in Japanese women with GDM. Materials and Methods This retrospective study analyzed 537 Japanese women with GDM. Participants were categorized by BMI (underweight <18.5 kg/m2, normal, and obesity ≥25.0 kg/m2) and by weight quartiles at age 20 and pre‐pregnancy. Multivariable logistic regression analyses were performed to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the association between underweight at age 20 and pre‐pregnancy and LGA. Results The prevalence of underweight at age 20, underweight pre‐pregnancy, and LGA was 30.4%, 13.4%, and 9.7%, respectively. After adjustment for confounders, underweight based on BMI at age 20 (adjusted OR 0.22, 95% CI: 0.06–0.75) and pre‐pregnancy (adjusted OR 0.17, 95% CI: 0.03–0.64) was significantly and inversely associated with LGA compared with obesity. Similarly, the lowest weight quartiles at both time points were independently associated with a low risk of LGA. Conclusions Maternal underweight at age 20 and pre‐pregnancy was significantly associated with a lower risk of LGA in Japanese women with GDM. These findings suggest that weight status from early adulthood may play a crucial role in fetal growth outcomes.

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Cite

BibTeXRIS
BibTeX
@article{furukawa2026underweight,
  title = {{Underweight at age 20 and pre‐pregnancy and large‐for‐gestational‐age births in Japanese women with gestational diabetes mellitus: Hamamatsu GRACE Study 4}},
  author = {Shinya Furukawa and Ayumi Kanamoto and Yukino Toyama and Kei Takeshita and Takuya Hashimoto and Teruki Miyake and Daisuke Tsuriya},
  journal = {Journal of Diabetes Investigation},
  year = {2026},
  month = nov,
  doi = {10.1111/jdi.70393},
  url = {https://doi.org/10.1111/jdi.70393},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Underweight at age 20 and pre‐pregnancy and large‐for‐gestational‐age births in Japanese women with gestational diabetes mellitus: Hamamatsu GRACE Study 4
AU  - Shinya Furukawa
AU  - Ayumi Kanamoto
AU  - Yukino Toyama
AU  - Kei Takeshita
AU  - Takuya Hashimoto
AU  - Teruki Miyake
AU  - Daisuke Tsuriya
PY  - 2026
DA  - 2026/11/02
JO  - Journal of Diabetes Investigation
DO  - 10.1111/jdi.70393
UR  - https://doi.org/10.1111/jdi.70393
AB  - Aims/Introduction While maternal obesity is a well‐established risk factor for large‐for‐gestational‐age (LGA) infants, the impact of maternal underweight on LGA in women with gestational diabetes mellitus (GDM) remains inconsistent. This issue is particularly relevant in Japan, given the high prevalence of underweight women. We investigated the association between maternal weight and body mass index (BMI) at age 20 and pre‐pregnancy and the risk of LGA in Japanese women with GDM. Materials and Methods This retrospective study analyzed 537 Japanese women with GDM. Participants were categorized by BMI (underweight <18.5 kg/m2, normal, and obesity ≥25.0 kg/m2) and by weight quartiles at age 20 and pre‐pregnancy. Multivariable logistic regression analyses were performed to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the association between underweight at age 20 and pre‐pregnancy and LGA. Results The prevalence of underweight at age 20, underweight pre‐pregnancy, and LGA was 30.4%, 13.4%, and 9.7%, respectively. After adjustment for confounders, underweight based on BMI at age 20 (adjusted OR 0.22, 95% CI: 0.06–0.75) and pre‐pregnancy (adjusted OR 0.17, 95% CI: 0.03–0.64) was significantly and inversely associated with LGA compared with obesity. Similarly, the lowest weight quartiles at both time points were independently associated with a low risk of LGA. Conclusions Maternal underweight at age 20 and pre‐pregnancy was significantly associated with a lower risk of LGA in Japanese women with GDM. These findings suggest that weight status from early adulthood may play a crucial role in fetal growth outcomes.
SN  - 2040-1124
SN  - 2040-1116
ER  -