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Maternal hyperglycemia associated with risk for childhood obesity
Hyperglycemia screening, treatment may decrease risk for obesity in offspring.
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Hyperglycemia in pregnancy is related to future risk for obesity in children in a specific age range, according to results of a study published in Diabetes Care. Based on these findings, researchers suggested that treatment of gestational diabetes resulted in childhood obesity rates closer to normal.
Teresa A. Hillier, MD, endocrinologist at Kaiser Permanente’s Center for Health Research Northwest and Hawaii, and associates selected mother–child pairs who had remained Kaiser Permanente members five to seven years postpartum. The study, funded by the American Diabetes Association, showed a positive trend for increased childhood obesity based on U.S. populations norms from 1963 to 1994.
“Because of adiposity rebound, children who are obese at age 5 to 7 years are likely to be obese as adults,” she said.
Glucose tolerance test given
Hillier and colleagues evaluated 9,439 multiethnic mother–child pairs in the Pacific Northwest and Hawaii. They performed a 50-g, one-hour glucose challenge test on pregnant women in two Kaiser Permanente regions from 1995 to 2000. Women who failed this test at a level of >7.8 mmol/L were then diagnosed up to and including a 100-g, three-hour oral glucose tolerance test. From this sample, the researchers evaluated a large number of mothers whose glucose intolerance ranged from normal to gestational diabetes.
The percentages of mothers with normal glucose tolerance, a positive glucose challenge test with normal OGTT results, one abnormal value on an OGTT and gestational diabetes did not differ from the excluded group, according to the study.
Children of mothers in the highest quartile of hyperglycemia were associated with a significantly higher level of childhood obesity (P<.0001 for both >85th and >95th percentiles).
The researchers wrote that the risk for obesity for all levels of hyperglycemia, based on >1 abnormal OGTT values, remained significant. However, the children of mothers who had been treated for gestational diabetes showed risk similar to the children of women with normal glucose tolerance.
The direct association between maternal hyperglycemia and childhood obesity remained after multivariate adjustment for maternal age, parity, weight gain, ethnicity, macrosomia at birth and the sex of the child.
“Even in cases of severe gestational diabetes, the risk for mothers who received treatment was attenuated compared to untreated mothers with a lesser degree of hyperglycemia,” Hillier said.
Results were consistent among many racial groups, according to Hillier, however further research is warranted.
“The good news is that with treatment, the trend appears reversible,” she said. – by Rob Volansky
For more information:
- Hillier TA, Pedula KL, Schmidt MM, et al. Childhood obesity and metabolic imprinting: the ongoing effects of maternal hyperglycemia. Diabetes Care. 2007;30:2287-2292.