The Association Between Glucose Intolerance and Longitudinal Fetal Growth in Nulliparas.
Abstract
Objective
To evaluate fetal growth patterns and birth weight among individuals with normoglycemia, mild glucose intolerance, and gestational diabetes mellitus (GDM) from midgestation until delivery.Methods
This is a secondary analysis of the NuMoM2b (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be) prospective cohort of nulliparous individuals with singleton gestations. Maternal glucose tolerance was categorized as normal, mild glucose intolerance (one abnormal Carpenter-Coustan value), or GDM. Blinded ultrasounds at 16-22 weeks and 22-29 weeks provided fetal biometry z scores; suspected large for gestational age (LGA) was defined as an abdominal circumference or estimated fetal weight above the 90th percentile on ultrasound; LGA was confirmed as birth weight above the 90th percentile for gestational age and sex. Logistic regression and covariance pattern models assessed the association between glycemic status and LGA growth across time points.Results
Among 7,010 included participants, 175 (2.5%) had mild glucose intolerance, and 290 (4.1%) had GDM. Fetal biometry was similar across groups at 16-22 weeks. By 22-29 weeks, GDM was associated with accelerated fetal growth z scores, and both mild glucose intolerance and GDM were associated with increased odds of abdominal circumference above the 90th percentile (adjusted odds ratio [AOR] 1.64, 95% CI, 1.08-2.50 and AOR 1.54, 95% CI, 1.10-2.16, respectively). By delivery, mild glucose intolerance carried a twofold increased risk for LGA birth weight (AOR 2.00, 95% CI, 1.29-3.10), whereas the LGA risk in those with GDM was similar to that in normoglycemic individuals (AOR 1.34, 95% CI, 0.91-1.98).Conclusion
Fetal overgrowth associated with glucose intolerance emerges around the standard 24- to 28-week GDM screening window. Individuals with GDM had an LGA risk similar to those with normal glucose tolerance, consistent with the increased surveillance and clinical management associated with a GDM diagnosis attenuating the trajectory of excess fetal growth. Whether treatment of mild glucose intolerance can reduce LGA risk remains to be determined.Clinical trial registration
ClinicalTrials.gov, NCT01322529.
Related
- Association Between Cholesterol‐HDL‐Glucose (CHG) Index and New‐Onset Hypertension Across Different Sex and Glycemic Status: A Longitudinal Study With 9‐Year Follow‐Up
- Intergenerational inheritance of paternal metabolic disorder: miR-29a/c-3p/glucose-6-phosphatase 1 axis in glucose intolerance propagation
- Association between the cholesterol-high-density lipoprotein-glucose index and new-onset stroke in middle-aged and older adults with depressive symptoms: a longitudinal cohort analysis
- Continuous caloric restriction and diet replacement but not alternate-day fasting may enhance susceptibility to glucose intolerance, dyslipidemia and cell stress under renewed high-fat diet.
- Association Between Time-Weighted Haemoglobin A1c and Longitudinal Changes in Growth Parameters Among Children With Type 1 Diabetes: A Retrospective Cohort Study.
BibTeX
@article{mahdasianmiller2026association,
title = {{The Association Between Glucose Intolerance and Longitudinal Fetal Growth in Nulliparas.}},
author = {Alexandra Mahdasian-Miller and Armando Peña and David Haas and Maisa Feghali and Lynn Yee and Jessica Wilder and Nathan Blue and Celeste Durnwald and Jonathan Steller and Christina M Scifres},
journal = {O\&G open},
year = {2026},
month = oct,
doi = {10.1097/og9.0000000000000213},
url = {https://europepmc.org/article/MED/42948549},
note = {CC BY},
}
RIS
TY - JOUR
TI - The Association Between Glucose Intolerance and Longitudinal Fetal Growth in Nulliparas.
AU - Alexandra Mahdasian-Miller
AU - Armando Peña
AU - David Haas
AU - Maisa Feghali
AU - Lynn Yee
AU - Jessica Wilder
AU - Nathan Blue
AU - Celeste Durnwald
AU - Jonathan Steller
AU - Christina M Scifres
PY - 2026
DA - 2026/10/27
JO - O&G open
DO - 10.1097/og9.0000000000000213
UR - https://europepmc.org/article/MED/42948549
AB - Objective To evaluate fetal growth patterns and birth weight among individuals with normoglycemia, mild glucose intolerance, and gestational diabetes mellitus (GDM) from midgestation until delivery.Methods This is a secondary analysis of the NuMoM2b (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be) prospective cohort of nulliparous individuals with singleton gestations. Maternal glucose tolerance was categorized as normal, mild glucose intolerance (one abnormal Carpenter-Coustan value), or GDM. Blinded ultrasounds at 16-22 weeks and 22-29 weeks provided fetal biometry z scores; suspected large for gestational age (LGA) was defined as an abdominal circumference or estimated fetal weight above the 90th percentile on ultrasound; LGA was confirmed as birth weight above the 90th percentile for gestational age and sex. Logistic regression and covariance pattern models assessed the association between glycemic status and LGA growth across time points.Results Among 7,010 included participants, 175 (2.5%) had mild glucose intolerance, and 290 (4.1%) had GDM. Fetal biometry was similar across groups at 16-22 weeks. By 22-29 weeks, GDM was associated with accelerated fetal growth z scores, and both mild glucose intolerance and GDM were associated with increased odds of abdominal circumference above the 90th percentile (adjusted odds ratio [AOR] 1.64, 95% CI, 1.08-2.50 and AOR 1.54, 95% CI, 1.10-2.16, respectively). By delivery, mild glucose intolerance carried a twofold increased risk for LGA birth weight (AOR 2.00, 95% CI, 1.29-3.10), whereas the LGA risk in those with GDM was similar to that in normoglycemic individuals (AOR 1.34, 95% CI, 0.91-1.98).Conclusion Fetal overgrowth associated with glucose intolerance emerges around the standard 24- to 28-week GDM screening window. Individuals with GDM had an LGA risk similar to those with normal glucose tolerance, consistent with the increased surveillance and clinical management associated with a GDM diagnosis attenuating the trajectory of excess fetal growth. Whether treatment of mild glucose intolerance can reduce LGA risk remains to be determined.Clinical trial registration ClinicalTrials.gov, NCT01322529.
SN - 2994-9726
ER -