379: Maternal gestational diabetes mellitus and risk of long term pediatric infectious diseases of the offspring

Abstract

To assess whether in utero exposure to GDM increases the risk for long-term infectious morbidity of the offspring. A population-based cohort analysis was performed comparing total and different subtypes of infectious related pediatric diagnoses among offspring of mothers with GDM vs. offspring of mothers with no diabetes. The analysis included all singletons born between the years 1991-2014. Infectious related morbidities included hospitalizations involving a pre-defined set of ICD-9 codes. Mothers with pregestational diabetes, insufficient prenatal care, infants with congenital malformations, multiple gestations, and perinatal deaths were excluded from the analysis. A Cox proportional hazards model was constructed to adjust for confounders. The study population included 220,105 newborns which met the inclusion criteria; among them 4.3% (9,566) were born to mothers with GDM controlled by diet and exercise (GDM A1) and 0.3% (732) were born to mothers with GDM requiring oral treatment or insulin (GDM A2). During the follow-up period, children exposed in utero to GDM did not have a higher rate of long- term hospitalizations with diagnoses of infectious morbidity (11.1% of those without exposure to GDM vs. 11.3% of those who were exposed to GDM, p=0.516). However, gynecologic infections and orthopedic infections were significantly higher among those who were exposed to GDM (OR 1.68 for orthopedic infections, p=0.009, OR 3.38 for gynecological infections, p=0.007). While adjusting for confounders such as gestational age, mother age at birth and maternal hypertension, the association remained non significant with an adjusted hazards ratio of 0.97 (95% CI 0.92-1.03, p=0.429). There is no significant association between GDM and the rate of infectious hospitalizations of the offspring. However, in our population there was higher rate of gynecological and orthopedic infectious morbidity of the offspring among those who were exposed to GDM.View Large Image Figure ViewerDownload Hi-res image Download (PPT)