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Poster Session 2

Category: Diabetes

Poster Session 2

(631) Neonatal Fat Mass and Hypoglycemia in Infants of Pregnancies Complicated by Diabetes

Wednesday, February 11, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

Rachel L. Wiley, MD, MPH (she/her/hers)

Maternal Fetal Medicine Fellow
Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego
San Diego, California, United States

Coauthor(s)

Claire E. Jensen, MD, MSCR (she/her/hers)

Maternal Fetal Medicine Fellow
University of North Carolina
Chapel Hill, North Carolina, United States
Kim Boggess, MD

Professor
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina, United States
MJ

Marni B. Jacobs, PhD

Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego
San Diego, California, United States
Gladys A. Ramos, MD (she/her/hers)

Clinical Professor, Maternal Fetal Medicine
Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences
San Diego, California, United States

Objective:
Neonates of pregnancies affected by T2DM are at increased risk for complications, including hypoglycemia and long-term metabolic sequelae. Neonatal body composition may reflect in utero metabolic effects, but its association with neonatal hypoglycemia is unclear.

Study Design:
This is a secondary analysis of a multicenter randomized controlled trial investigating metformin use in pregnancies complicated by insulin treated T2DM and diabetes diagnosed in early pregnancy. Singleton, liveborn neonates delivered at >34 weeks with anthropometric measurements collected based on staff availability were included. Fat mass was calculated using skin fold measurements. The primary outcome was neonatal hypoglycemia was defined as an initial glucose < 40 mg/dL or requiring IV or oral treatment for hypoglycemia within 72 hours of birth. The association between fat mass and neonatal hypoglycemia was adjusted for gestational age, HbA1c at delivery and pre-existing diabetes.

Results:
Of 794 newborns born to participants in the primary trial, 418 (52.6%) newborns met inclusion criteria for this secondary analysis and 167 (39.9%) had hypoglycemia. Maternal characteristics differed between infants with hypoglycemia versus those normoglycemic. (Table 1). In both unadjusted and adjusted analysis, neonatal fat mass was higher in infants with hypoglycemia (525.5 g, 95% CI 453.0 – 597.0) compared to normoglycemia (429.9 g, 95%CI 362.1 – 497.6; p < 0.01, Figure 1), with significant differences in birthweight, fat free mass, body mass percentage and mid-upper arm circumference (Table 2).

Conclusion:
Increased fat mass and body fat percentage is associated with neonatal hypoglycemia. These findings suggest neonatal adiposity may reflect fetal metabolic effects of diabetes during pregnancy and warrant further investigation as a potential marker of future metabolic risk.