Association of gestational diabetes mellitus with offspring weight status across infancy: a prospective birth cohort study in China

Jiajin Hu,Lin Li,Yilin Liu,Xiaotong Wei,Yanan Ma,Yang Liu,Ming Gao,Deliang Wen

doi:10.1186/s12884-020-03494-7

Jiajin Hu, Lin Li + Show 6 more

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https://doi.org/10.1186/s12884-020-03494-7

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Abstract

BackgroundThe association between gestational diabetes mellitus (GDM) and childhood body weight remains controversial, and additional study is needed, especially in Asian populations.MethodsThis prospective study investigated the association between maternal glucose concentration, and GDM status and infant body weight from birth to 12 months of age. Linear mixed effects (LME) models and multiple linear regression were used to assess the longitudinal association of GDM with infant growth measured by weight-for-length z-scores (WFLZ), weight-for-age z-scores (WFAZ), and length-for-age z-scores (LFAZ) at birth, 1, 3, 6, 8, and 12 months of age.ResultsOffspring born to mothers with GDM had higher WFLZ [β: 0.26 SD units (95% CI: 0.13–0.40)] across infancy than those of mothers without GDM. When stratified analysis by maternal pre-pregnancy body mass index (BMI) status, the association was pronounced in normal-weight [β:0.28 SD units (95% CI: 0.11–0.45)] and overweight/obese women [β: 0.34 SD units (95% CI: 0.09–0.58)] but not in underweight women (P for interaction < 0.05). Multiple linear regression found that the effect estimate of GDM on infant WFLZ was highest at birth [β: 0.36 SD units (95% CI: 0.11–0.61)], remained significant at 1 [β: 0.22 SD units (95% CI: 0.03–0.41)] and 3 [β:0.19 SD units (95% CI: 0.01–0.37)] months of age and decreased across infancy. Maternal GDM status was not associated with infant WFAZ or LFAZ.ConclusionsMaternal GDM status was associated with infant WFLZ, but not WFAZ or LFAZ. The association between GDM status and offspring WFLZ was more pronounced in early infancy or in normal-weight and overweight/obese women. Increased public health efforts to prevent GDM in normal-weight and overweight/obese pre-pregnancy mothers are recommended to control offspring overweight or obesity.

Highlights

The association between gestational diabetes mellitus (GDM) and childhood body weight remains controversial, and additional study is needed, especially in Asian populations
To better define maternal targets for interventions to prevent childhood obesity, this study investigated the association between maternal hyperglycemia and GDM status and infant weight status from birth to 1 year of age using data obtained in the Born in Shenyang Birth Cohort Study (BISCS) [39]
After adjusting for sociodemographic characteristics and parental body mass index (BMI), the infants of mothers with GDM had higher weightfor-length z-scores (WFLZ) scores [β:0.26 Standard unit (SD) units] than those without GDM

Summary

Introduction

The association between gestational diabetes mellitus (GDM) and childhood body weight remains controversial, and additional study is needed, especially in Asian populations. Exposure to metabolic changes associated with gestational diabetes mellitus (GDM) may alter the in utero environment to increase the risk of obesity in later life. Some studies found that maternal hyperglycemia was associated with an increased risk of childhood overweight/obesity, but others did not [8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26]. The in utero effect of GDM on offspring may be time sensitive and may vary with the age of the child [5, 11, 20, 27, 28].

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