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Childhood obesity risk increased among girls exposed to gestational diabetes, hyperglycemia in utero
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Recent study data published in Diabetes Care suggest that girls exposed to gestational diabetes mellitus of subclinical hyperglycemia in utero have an increased risk of childhood obesity.
The risk was further elevated if the mother was overweight or obese prior to pregnancy, according to researchers.
Researchers evaluated 421 girls and their mothers to determine the associated between maternal pregnancy hyperglycemia, gestational diabetes and offspring adiposity.
The children were aged 6 to 8 years from a variety a ethnic origin and followed up for a mean 3.8 years. Anthropometric measurements and Tanner staging for signs of pubety were evaluated at each follow-up visit. Maternal glucose levels were classified by quintiles of the glucose value and the researchers compared those in the second to fifth quintile to those in the first or lowest quintile. Women in the fifth quintile were further categorized at those with gestational diabetes and those without gestational diabetes.
The study’s primary outcomes included the following three indicators of the children’s adiposity: age-specific BMI ³85th percentile, body fat percentage and waist-to-height ratio.
The researchers found that when mothers in the highest glucose quintile were stratified based on the presence or absence of gestational diabetes, there was a greater risk of higher age-specific BMI percentile (OR=3.56; 95% CI, 1.28-9.92), body fat percentage (OR=3.13; 95% CI, 1.08-9.09) and higher waist-to-height ratio (OR=2.8; 95% CI, 1-7.84) in girls whose mothers had gestational diabetes vs. those whose mothers did not.
The researchers also found a significant relationship between pregravid overweight (BMI ³25 kg/m2) and gestational diabetes. Mothers who had both of these risk factors were most likely to have daughters with BMI ³85th percentile (OR=5.56; 95% CI, 1.7-18.2), body fat in the highest quartile (OR=6.04; 95% CI, 1.76-20.7) and waist-to-hip ratio in the highest quartile (OR=3.6; 95% CI, 1.35-9.58), The researchers also identified weaker correlations between maternal subclinical hyperglycemia and adiposity in daughters.
“In conclusion, in this ethnically diverse sample of mother-daughter pairs, subclinical hyperglycemia and [gestation diabetes] were both found to be important predictors of offspring adiposity in girls, independent of maternal pregravid obesity,” the researchers wrote. “The concept of windows of susceptibility over the life course provides an important conceptual framework for understanding how prenatal exposures may influence the health of offspring and the cycle may continue over generations. Our study suggests that exposures during the intrauterine period affects the offspring’s obesity trajectory, which will subsequently shape health outcomes of the girls later in life. … Ongoing intervention studies targeting pregnant or preconceptual women have promising clinical and public health implications to slow the ever-increasing rate of obesity and diabetes in the United States.”
Disclosure: See the study for a complete list of the researchers relevant financial disclosures.
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