Abstract
Aims/hypothesisThere is evidence that, from birth, South Asians are fatter, for a given body mass, than Europeans. The role of developmental overnutrition related to maternal adiposity and circulating glucose in these ethnic differences is unclear. Our aim was to compare associations of maternal gestational adiposity and glucose with adiposity at age 4/5 years in white British and Pakistani children.MethodsBorn in Bradford is a prospective study of children born between 2007 and 2010 in Bradford, UK. Mothers completed an OGTT at 27–28 weeks of gestation. We examined associations between maternal gestational BMI, fasting glucose, post-load glucose and diabetes (GDM) and offspring height, weight, BMI and subscapular skinfold (SSF) and triceps skinfold (TSF) thickness at age 4/5 years, using data from 6060 mother–offspring pairs (2717 [44.8%] white British and 3343 [55.2%] Pakistani).ResultsPakistani mothers had lower BMI and higher fasting and post-load glucose and were twice as likely to have GDM (defined using modified WHO criteria) than white British women (15.8% vs 6.9%). Pakistani children were taller and had lower BMI than white British children; they had similar SSF and lower TSF. Maternal BMI was positively associated with the adiposity of offspring in both ethnic groups, with some evidence of stronger associations in Pakistani mother–offspring pairs. For example, the difference in adjusted mean BMI per 1 kg/m2 greater maternal BMI was 0.07 kg/m2 (95% CI 0.05, 0.08) and 0.10 kg/m2 (95% CI 0.09. 0.11) in white British and Pakistani children, respectively, with equivalent results for SSF being 0.07 mm (95% CI 0.05, 0.08) and 0.09 mm (95% CI 0.08. 0.11) (p for ethnic difference < 0.03 for both). There was no strong evidence of association of fasting and post-load glucose, or GDM, with outcomes in either group.Conclusions/interpretationAt age 4/5 years, Pakistani children are taller and lighter than white British children. While maternal BMI is positively associated with offspring adiposity, gestational glycaemia is not clearly related to offspring adiposity in either ethnic group.
Highlights
Increasing evidence suggests that greater maternal adiposity, circulating glucose and gestational diabetes (GDM) cause, via intrauterine mechanisms, greater offspring birthweight and ponderal index at birth [1,2,3]
We have shown that, compared with white British women, Pakistani women have a lower early pregnancy BMI but higher gestational fasting and post-load glucose concentrations and higher prevalence of GDM
At age 4/5 years, their children are taller, have lower BMI and triceps skinfold (TSF) thickness and similar subscapular skinfold (SSF) thickness. In both groups of women, greater maternal BMI was associated with higher offspring height, weight, BMI and TSF and SSF thickness, with some evidence of stronger associations in Pakistani compared with white British mother–offspring pairs
Summary
Increasing evidence suggests that greater maternal adiposity, circulating glucose and gestational diabetes (GDM) cause, via intrauterine mechanisms, greater offspring birthweight and ponderal index at birth [1,2,3]. There is evidence that exposure to GDM in-utero results in greater offspring adiposity and overweight/obesity in infancy and early adulthood (to date there have been no reports for older ages) [1, 6] but few studies have reported associations with fasting and post-load glucose following universal oral glucose tolerance testing, as opposed to studies in which the OGTT was confined to at-risk women. The latter is important, as studies in which universal risk factor screening followed by OGTT in only those with risk factors might result in bias due to preferential diagnosis testing in obese women [1, 7, 8]. There is inconsistent evidence regarding the role of maternal fasting and post-load gestational glucose in ethnic differences in offspring adiposity beyond birth or infancy [8, 21] and, to our knowledge, no studies have explored whether maternal BMI and glycaemia traits differ in their associations with offspring measures of growth and adiposity between white European and South Asian mother–offspring pairs
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