Background: With the increasing rates of GDM and variations in screening guidelines, this study sought to investigate the relationship between GDM and LGA across the U.S.

Methods: This is a retrospective cohort study using National Vital Statistics data (2012-2018) . We included singleton, non-anomalous births with gestational age of 23-42 weeks and excluded women with pre-existing diabetes. The states were divided into four regions (Northeast, Midwest, South, and West) . Chi-square test and multivariable logistic regression models were used.

Results: In the cohort of 24,938,357 births, 14.5% were in Northeast, 21.7% in Midwest, 39.2% in South and 24.6% in West. Midwest had higher prevalence of GDM (6.4%) as well as LGA (10.9%, Figure 1) . After adjusting for maternal race, age, education, BMI, prenatal care, smoking status, hypertension, and year of delivery, risk of LGA is highest in women from South with GDM (aOR=1.16, 95%CI:1.14-1.18) as compared to women from West with GDM.

Conclusions: Further studies are needed to determine factors associated with rising rates of LGA.


M.L.Hernandez-zepeda: None. B.Garg: None. A.M.Valent: None.

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