Abstract
BackgroundThe prevalence of diabetes mellitus (DM) during pregnancy and childhood obesity is increasing worldwide. Factors affecting the growth of children with overweight whose mothers had DM are complicated and inconclusive. Few longitudinal studies have focused on the growth of infants with macrosomia born to mothers with DM and the factors influencing their overweight. This study explored risk factors for childhood overweight/obesity (OWOB) among children of mothers with DM. Perinatal, maternal socio-demographic, infant care, and maternal body weight characteristics as well as child growth until age 3 years were analyzed using a longitudinal design.MethodsIn total, 24,200 pairs of mothers and their children from the Taiwan Birth Cohort Study were included. Combined Taiwan Children Growth Curve report classifications were analyzed for infant growth at birth and at 6, 12, 18, 24, and 36 months old (m/o). A multiple logistic regression analysis with different model settings was used to assess factors affecting the growth of high birth weight children of mothers with diabetic mellitus (HODM).ResultsChildren in the HODM group had a higher average body weight than did those in the non-DM group at different age stages. Relative to the non-DM group, weight gain in the HODM group was slower before 18 m/o but faster from 18 to 36 m/o, particularly after 24 m/o. Maternal DM was a major risk factor for childhood OWOB (odds ratio [OR]: 3.25–3.95). After adjustment for related confounders, the OR was 2.19–3.17. Maternal overweight or obesity and higher gestational weight gain were greater risk factors for childhood OWOB at 3 years old after adjusted maternal DM and other selected confounders (OR: 1.45 and 1.23, respectively). Breastfeeding until 6 m/o was a protective factor against childhood OWOB (OR: 0.95). The HODM and non-DM groups did not differ significantly in perinatal, maternal socio-demographic, or infant care characteristics.ConclusionsMaternal DM is a major factor of childhood OWOB. Maternal body weight before and after pregnancy affects childhood OWOB, and this effect increases with the child’s age.
Highlights
The prevalence of diabetes mellitus (DM) during pregnancy and childhood obesity is increasing worldwide
446 (2.16%) children were born to mothers with diagnosed DM during pregnancy
Maternal body mass index (BMI) before and after pregnancy were higher in the DM groups than in the nonDM group
Summary
The prevalence of diabetes mellitus (DM) during pregnancy and childhood obesity is increasing worldwide. Few longitudinal studies have focused on the growth of infants with macrosomia born to mothers with DM and the factors influencing their overweight. This study explored risk factors for childhood overweight/ obesity (OWOB) among children of mothers with DM. The prevalence of diabetes mellitus (DM) is increasing rapidly worldwide and is the most common complication of pregnancy, affecting up to 10% of expectant mothers [1]. Infants exposed to high glucose levels prenatally have an increased risk of long-term adverse outcomes, including childhood overweight and obesity (OWOB). Many studies have demonstrated that mothers with higher body mass index (BMI) are more likely to have overweight infants [4]. In addition to genetic and DM factors of child obesity, the effects of family lifestyle [6], breastfeeding, parents’ education level, and even whether mothers who are able to perceive their children’s body weight status accurately have been discussed [7, 8]
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