Gestational Diabetes Affects Adiposity Of Children Later In Life

Nutrition Research Newsletter, Sept, 1999 by Betty R. Vohr, Stephen T. McGarvey, Richard Tucker

Two to three percent of all pregnant women will develop gestational diabetes mellitus (GDM), a disease that places both the mother and child at risk for complications. It has previously been shown that offspring born to mothers with GDM are more likely to have higher levels of adiposity at birth and at age one than are infants born to mothers without GDM. Higher levels of adiposity during childhood and infancy may be associated with the increased risk of long-term health complications including high blood pressure and glucose intolerance. Recently, investigators set out to determine the effects of maternal prenatal factors, including the presence of GDM, on the prevalence of adiposity in children at ages four to seven.

A prospective, longitudinal study, including 207 women, was performed to assess the effect of GDM, adiposity, and weight gain during pregnancy on childhood adiposity. A secondary purpose of this research was to further study the relationships among childhood adiposity, blood pressure, and 2-h postprandial glucose levels at 4, 5, 6, and 7 years of age. The subjects were divided into four distinct groups, which included large-for-gestational-age (LGA) offspring of mothers with GDM, appropriate-for-gestational-age (AGA) infants of mothers with GDM, LGA control subjects with mothers without GDM, and AGA infants of mothers without GDM. Anthropometrics, including height, weight, head circumference, and subcutaneous skin folds were obtained at each visit to the clinic. Blood pressure and 2-h postprandial glucose tests were also administered at each clinic visit.

One hundred and six mothers with GDM and 101 control mothers participated in this study. It was found that LGA infants who had mothers with GDM had significantly higher BMI's, were more likely to be heavier and to have a larger head circumference than AGA infants born to mothers with GDM and all control subjects. There were no significant differences in blood pressures or postprandial glucose values between the four groups at 4-7 years of age. The BMI of the infant as well as the prepregnant BMI of the mother were found to be predictive of the 7-year-old BMI for the offspring of mothers with GDM. In the control subjects, maternal prepregnancy BMI and the amount of weight gained throughout the pregnancy were the positive predictors for the 7-year-old BMI.

It can be concluded that LGA infants whose mothers experienced GDM have increased adiposity and body size during childhood when compared to AGA infants of mothers with GDM and control infants. This increase in adiposity and body size may negatively impact health as these children grow into adulthood. Further longitudinal studies are needed to assess these findings and their long-term effects.

Betty R. Vohr, Stephen T. McGarvey, Richard Tucker, Effects of Maternal Getational Diabetes on Offspring Adiposity at 4-7 Years of Age, Diabetes Care, 22:1284-1291 (August 1999) [Correspondence: Betty R. Vohr, MD, Dept. of Pediatrics, Women and Infants' Hospital, 101 Dudley St., Providence, RI 02905. E-mail betty_vohr@brown.edu.]