ASSOCIATIONS OF GESTATIONAL DIABETES TREATMENT WITH MATERNAL WEIGHT CHANGE AND NEWBORN BIRTHWEIGHT
Author(s)
Brianna M. Cartwright, MS, Karen Gilbert Farrar, PhD, Duy Hoang, PhD, Nina B. Masters, PhD.
Truveta, Inc., Bellevue, WA, USA.
Truveta, Inc., Bellevue, WA, USA.
OBJECTIVES: To assess real-world gestational diabetes mellitus (GDM) treatment use and associations with maternal weight change and large-for-gestational-age (LGA) infants.
METHODS: Using linked electronic health records and closed claims data from Truveta, we identified women aged 16-50 years who underwent a 1-hour glucose tolerance test (GTT) between 2018 and August 2025 during their first pregnancy. Eligible women had continuous medical claims coverage from 24-42 weeks’ gestation, gestational age diagnosis codes, and no prior type 1 or type 2 diabetes. GDM status was defined using 3-hour GTT laboratory values or diagnosis codes. Nutrition counseling and initiation of insulin or metformin were identified within 45 days of glucose testing. Maternal weight change was defined as the difference between weight closest to the 1-hour GTT and maximum pre-birth weight. LGA was defined as infant birthweight >4000g within one day of delivery. Multivariable linear (maternal weight) and logistic (LGA) regression models assessed associations between treatment receipt, maternal weight change, and LGA risk.
RESULTS: Among 37,992 pregnant women with 1-hour GTTs, 8.7% had GDM; among these, 42.6% received nutrition counseling within 45 days, 15.4% initiated insulin, and 10.3% initiated metformin. Nutrition counseling was associated with significantly lower maternal weight gain (β = -1.60; 95% CI -2.50, -0.70; p<0.001). Newborn weight data were available for 7,218 infants. Nutrition counseling and insulin were not associated with LGA risk; however, metformin (OR = 0.92; 95% CI 0.89, 0.95; p<0.001), Asian race, Hispanic or Latino ethnicity, female infant sex, absence of GDM, and lower maternal pre-pregnancy BMI were associated with decreased LGA risk.
CONCLUSIONS: In this large real-world pregnancy cohort, nutrition counseling following GDM diagnosis was associated with reduced maternal weight gain, but not LGA risk. These findings suggest nutrition counseling may benefit maternal outcomes, while further research is needed to understand its effects on infant birthweight.
METHODS: Using linked electronic health records and closed claims data from Truveta, we identified women aged 16-50 years who underwent a 1-hour glucose tolerance test (GTT) between 2018 and August 2025 during their first pregnancy. Eligible women had continuous medical claims coverage from 24-42 weeks’ gestation, gestational age diagnosis codes, and no prior type 1 or type 2 diabetes. GDM status was defined using 3-hour GTT laboratory values or diagnosis codes. Nutrition counseling and initiation of insulin or metformin were identified within 45 days of glucose testing. Maternal weight change was defined as the difference between weight closest to the 1-hour GTT and maximum pre-birth weight. LGA was defined as infant birthweight >4000g within one day of delivery. Multivariable linear (maternal weight) and logistic (LGA) regression models assessed associations between treatment receipt, maternal weight change, and LGA risk.
RESULTS: Among 37,992 pregnant women with 1-hour GTTs, 8.7% had GDM; among these, 42.6% received nutrition counseling within 45 days, 15.4% initiated insulin, and 10.3% initiated metformin. Nutrition counseling was associated with significantly lower maternal weight gain (β = -1.60; 95% CI -2.50, -0.70; p<0.001). Newborn weight data were available for 7,218 infants. Nutrition counseling and insulin were not associated with LGA risk; however, metformin (OR = 0.92; 95% CI 0.89, 0.95; p<0.001), Asian race, Hispanic or Latino ethnicity, female infant sex, absence of GDM, and lower maternal pre-pregnancy BMI were associated with decreased LGA risk.
CONCLUSIONS: In this large real-world pregnancy cohort, nutrition counseling following GDM diagnosis was associated with reduced maternal weight gain, but not LGA risk. These findings suggest nutrition counseling may benefit maternal outcomes, while further research is needed to understand its effects on infant birthweight.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
CO110
Topic
Clinical Outcomes
Topic Subcategory
Performance-based Outcomes
Disease
SDC: Pediatrics, STA: Nutrition