Maternal Diabetes Tied to Infection Risk in Infants

TOPLINE:

Both maternal gestational and pregestational diabetes were associated with an increased risk for infections in infants during the first 6 months of life, a prospective study showed. Maternal pregestational diabetes was also associated with reduced neonatal immunoglobulin G (IgG) repertoire diversity, and infants of mothers with diabetes who had low IgG diversity had a higher risk for infections than infants of mothers without diabetes with high IgG diversity.

METHODOLOGY:

Maternal diabetes during pregnancy has been associated with adverse maternal and child health outcomes and altered infant immune function, leaving newborns and infants younger than 6 months especially vulnerable to infections.
Researchers analyzed 2702 mother-infant pairs from the Boston Birth Cohort, enrolled at birth and followed up prospectively, to examine whether maternal diabetes in pregnancy was associated with the risk for offspring infections in the first 6 months of life.
Umbilical cord blood was collected at birth, and a subset of 971 participating pairs underwent cord blood IgG antibody profile quantification for various microbes.
Pregestational and gestational diabetes were defined using physician diagnosis, laboratory testing, and prescription of glucose-lowering medications; infections in infants during the first 6 months of life were defined using physician diagnoses.

TAKEAWAY:

Among the included participants, 12.1% of infants were born to mothers with gestational diabetes and 5.1% to mothers with pregestational diabetes; 15.4% of infants experienced at least one infection during the first month of life, and 52.7% experienced at least one infection within the first 6 months.
Maternal gestational diabetes (risk ratio [RR], 1.20; 95% CI, 1.09-1.32) and pregestational diabetes (RR, 1.28; 95% CI, 1.12-1.47) were each associated with an elevated risk for infections in infants during the first 6 months of life.
The association between maternal diabetes and an increased risk for infection in infants was especially marked for pregestational diabetes among infants born preterm or delivered via cesarean section.
Maternal pregestational diabetes was linked to a reduced global IgG repertoire diversity in newborns, and this effect was more pronounced among infants whose mothers were overweight or obese before pregnancy.
Infants born to mothers with diabetes coupled with lower IgG repertoire diversity were at a higher risk for infections than their peers born to mothers with no diabetes and high IgG diversity.

IN PRACTICE:

“Our findings raise the possibility that appropriate screening and management of maternal diabetes across the entire gestational period and reducing rate of preterm birth and C-section may reduce the risk of infections in early life and achieve long-lasting benefits. Infection prevention strategies are critical for infants born to mothers with diabetes, and these infants should be treated promptly if they develop an infection,” the authors of the study wrote.

SOURCE:

The study was led by Guoying Wang, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore. It was published online in Diabetes Care.

LIMITATIONS:

The study’s technology could not detect IgG against capsular polysaccharide and the protective capacity of IgG antibodies. Researchers did not assess infant circulating IgG repertoire in the first 6 months, limiting conclusions about the duration of maternally derived antibody presence. Early-life infections were defined on the basis of standard diagnostic codes, which restricted analysis of infections by specific pathogen or categories.

DISCLOSURES:

The study received support from the National Institutes of Health Clinical and Translational Science Awards, the American Diabetes Association grant, and other sources including multiple National Institutes of Health institutes. One author disclosed being a founder of Infinity Bio, while another author reported being a paid consultant for the same company.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.