Prognostic significance of birth of large infant for subsequent development of maternal non-insulin-dependent diabetes mellitus: a prospective study over 20-27 years.

In a prospective study, 270 women who gave birth to infants weighing greater than or equal to 4500 g (large baby, LB) underwent an oral glucose tolerance test (OGTT) within the first week of the puerperium. Of these women, 179 (66.3%) were retested 3-10 yr later, and 236 (87.4%) were also evaluated 20-27 yr later. The frequency of pathologic OGTTs increased with time, but the tests were of little prognostic significance for the individual patient. Women who had borne LBs developed non-insulin-dependent diabetes mellitus (NIDDM) six times more often than did a control group of women matched for age and parity and with the same period of follow-up. However, patients who developed NIDDM were also very obese, of high parity, and had a positive family history for diabetes mellitus in a high percentage of cases. Women with LBs as the only risk factor did not develop NIDDM in our study. We conclude that the birth of one LB is of minor, if any, importance in the subsequent development of NIDDM.