{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:16:11Z","timestamp":1790802971575,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T00:00:00Z","timestamp":1703203200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Previous studies indicated an association between fetal overgrowth and maternal obesity independent of gestational diabetes mellitus (GDM). However, the underlying mechanisms beyond this possible association are not completely understood. This study investigates metabolic changes and their association with fetal and neonatal biometry in overweight and obese mothers who remained normal glucose\u2010tolerant during gestation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and methods<\/jats:title>\n                    <jats:p>In this prospective cohort study 893 women who did not develop GDM were categorized according to their pregestational body mass index (BMI): 570 were normal weight, 220 overweight and 103 obese. Study participants received a broad metabolic evaluation before 16\u2009weeks and were followed up until delivery to assess glucose levels during the oral glucose tolerance test (OGTT) at mid\u2010gestation as well as fetal biometry in ultrasound and pregnancy outcome data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Increased maternal BMI was associated with an adverse metabolic profile at the beginning of pregnancy, including a lower degree of insulin sensitivity (as assessed by the quantitative insulin sensitivity check index) in overweight (mean difference: \u22122.4, 95%\u2009CI \u22122.9 to \u22121.9,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and obese (mean difference: \u22124.3, 95%\u2009CI \u22125.0 to \u22123.7,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) vs normal weight women. Despite not fulfilling diagnosis criteria for GDM, overweight and obese mothers showed higher glucose levels at fasting and during the OGTT. Finally, we observed increased measures of fetal subcutaneous tissue thickness in ultrasound as well as higher proportions of large\u2010for\u2010gestational\u2010age infants in overweight (18.9%, odds ratio [OR] 1.74, 95%\u2009CI 1.08\u20132.78,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.021) and obese mothers (21.0%, OR 1.99, 95%\u2009CI 1.06\u20133.59,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.027) vs normal weight controls (11.8%). The risk for large for gestational age was further determined by OGTT glucose (60\u2009min: OR 1.11, 95%\u2009CI 1.02\u20131.21,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013; 120\u2009min: OR 1.13, 95%\u2009CI 1.02\u20131.27,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.025, for the increase of 10\u2009mg\/dL) and maternal triglyceride concentrations (OR 1.11, 95%\u2009CI 1.01\u20131.22,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.036, for the increase of 20\u2009mg\/dL).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Mothers affected by overweight or obesity but not GDM had a higher risk for fetal overgrowth. An impaired metabolic milieu related to increased maternal BMI as well as higher glucose levels at mid\u2010gestation may impact fetal overgrowth in women still in the range of normal glucose tolerance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.14688","type":"journal-article","created":{"date-parts":[[2023,12,23]],"date-time":"2023-12-23T01:08:44Z","timestamp":1703293724000},"page":"257-265","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Maternal overweight and obesity and its association with metabolic changes and fetal overgrowth in the absence of gestational diabetes mellitus: A prospective cohort study"],"prefix":"10.1111","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5914-4517","authenticated-orcid":false,"given":"C\u00e9cile","family":"Monod","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology University Hospital Basel  Basel 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Charit\u00e9\u2010Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt\u2010Universit\u00e4t zu Berlin, and Berlin Institute of Health  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Mosimann","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University Hospital Basel  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Henrich","sequence":"additional","affiliation":[{"name":"Clinic of Obstetrics Charit\u00e9\u2010Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt\u2010Universit\u00e4t zu Berlin, and Berlin Institute of Health  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Tura","sequence":"additional","affiliation":[{"name":"CNR Institute of Neuroscience  Padua 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