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Maternal diabetes and infant infections were extracted from electronic medical records. Cord blood IgG antibodies against a wide range of microbes were quantified using Phage ImmunoPrecipitation Sequencing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Overall, 327 infants (12.1%) were born to mothers with gestational diabetes mellitus (GDM) and 138 (5.1%) to mothers with pregestational diabetes mellitus (PDM). Of these, 416 infants (15.4%) and 1,425 infants (52.7%) had at least one infection in the neonatal period and the first 6 months of life, respectively. Compared with no diabetes, both maternal GDM (risk ratio [RR] 1.20, 95% CI 1.09\u20131.32) and PDM (RR 1.28, 95% CI 1.12\u20131.47) were significantly associated with an elevated risk of infections in infants during the first 6 months. These associations were particularly pronounced among infants born preterm, delivered via cesarean section, or with lower IgG repertoire diversity. Additionally, PDM was associated with a lower newborn\u2019s global IgG repertoire diversity, compared with no diabetes, with the effect more marked among infants whose mothers had prepregnancy overweight or obesity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>This study provides strong evidence of an increased infection risk in the infants of mothers with diabetes and a reduced IgG repertoire diversity in those of PDM mothers. Lower IgG diversity exacerbated the diabetes-infection link. These findings suggest that maternal metabolic conditions may impact an infant\u2019s passive immunity and susceptibility to infections.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc25-0990","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T16:55:21Z","timestamp":1768236921000},"page":"410-418","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":3,"title":["Impact of Maternal Diabetes in Pregnancy on Newborn IgG Antibody Repertoire and Infection Risk in the First 6 Months of Life"],"prefix":"10.2337","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9423-8946","authenticated-orcid":false,"given":"Guoying","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health 1 , Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingo","family":"Ruczinski","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health 2 , Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. 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