Objective: Maternal glycaemia and anthropometry-derived newborn adiposity are strongly
correlated. The children of mothers with diabetes are at greater risk of adverse metabolic
health, and increased adiposity is a plausible mediator. We undertook a systematic review and
meta-analysis to compare adiposity in infants of mothers with (IDM) and without diabetes
(NIDM).
Design: We identified observational studies reporting adiposity in IDM and NIDM. We searched
references, traced forward citations and contacted authors for additional data. We considered
all body composition techniques and compared fat mass, fat-free mass, body fat % and skinfold
thickness. We used random effects meta-analyses and performed subgroup analyses by
maternal diabetes type (type 1, type 2, gestational) and infant sex. We examined the influence
of pre-pregnancy BMI and conducted sensitivity analyses.
Results: We included data from 35 papers and over 24,000 infants. IDM have greater fat
mass than NIDM (mean difference [95% CI]); 83g [49, 117]. Fat mass is greater in infants of
mothers with gestational diabetes; 62g [29, 94] and type 1 diabetes; 268g [139, 397].
Insufficient studies reported data for type 2 diabetes separately. Compared with NIDM, fat
mass was greater in IDM boys; 87g [30, 145], but not significantly different in IDM girls; 42g [-
33, 116]. There was no attenuation after adjustment for maternal BMI.
Conclusions: IDM have significantly greater adiposity in comparison to NIDM. These findings
are justification for studies to determine whether measures to reduce infant adiposity will
improve later health.