The impact of pregnancy weight and glucose on the metabolic health of mother and child in the south west of the UK.
OBJECTIVE
to explore relationships between maternal pre-pregnancy weight, third trimester glucose, baby birth weight, weight and metabolic health of the mother and child 5 years after birth.


METHODS
an observational study set within a non-intervention, longitudinal cohort study looking at insulin resistance in children.


METHODS
a teaching hospital in the south west of the United Kingdom.


METHODS
300 mothers and their five-year-old children from randomly selected Plymouth schools, stratified according to socioeconomic status.


METHODS
were obtained from obstetric records maternal pre-pregnant weight, random and fasting third trimester blood glucose, baby birth weight. Five years later the following measurements were made of the mother and child: height, weight, glucose and insulin resistance.


RESULTS
five years after the pregnancy, 33% of the mothers were overweight, with an additional 19% obese. In the children 13% of boys were overweight (4% obese), and in the girls, 26% were overweight (5% obese). In the five-year-old children, weight (r=0.28, p<0.001) but not birth weight (r=0.03, p=0.573), correlated with insulin resistance. Maternal pre-pregnant weight was related to both random and fasting third trimester glucose, and to insulin resistance 5 years later. Third trimester fasting glucose, even within a normal range, was a better predictor than random glucose of the baby's birth weight (r=0.39, p=0.044) and the mother's future insulin resistance (r=0.67, p<0.001). No maternal measures predicted insulin resistance in the child at 5 years.


CONCLUSIONS
maternal weight had an important influence on the gestational environment, and predicted insulin resistance 5 years later. Fasting glucose, even within the reference range, was a better predictor than random glucose of the baby's birth weight and the mother's future insulin resistance.


CONCLUSIONS
these concern the importance of pre-conception weight management, and support replacement of routine random glucose sampling during the third trimester with an earlier, fasting measurement.
Jeffery
Alison N
AN
Peninsula Medical School, Plymouth Campus, UK.
Voss
Linda D
LD
Metcalf
Brad S
BS
Wilkin
Terence J
TJ
D000328:Adult; D001724:Birth Weight; D001786:Blood Glucose; D015992:Body Mass Index; D002657:Child Development; D002675:Child, Preschool; D015331:Cohort Studies; D004739:England; D005260:Female; D006304:Health Status; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000378:metabolism*; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011295:Prenatal Care / Q000592:standards*; D011446:Prospective Studies; D012107:Research Design; D013997:Time Factors; D015430:Weight Gain
D001786:Blood Glucose