Association of intrauterine exposure to maternal diabetes and obesity with type 2 diabetes in youth: the SEARCH Case-Control Study.
OBJECTIVE
Limited data exist on the association between in utero exposure to maternal diabetes and obesity and type 2 diabetes in diverse youth. These associations were explored in African-American, Hispanic, and non-Hispanic white youth participating in the SEARCH Case-Control Study.


METHODS
A total of 79 youth with type 2 diabetes and 190 nondiabetic control youth aged 10-22 years attended a research visit. In utero exposures to maternal diabetes and obesity were recalled by biological mothers.


RESULTS
Youth with type 2 diabetes were more likely to have been exposed to maternal diabetes or obesity in utero than were nondiabetic control youth (P < 0.0001 for each). After adjusting for offspring age, sex, and race/ethnicity, exposure to maternal diabetes (odds ratio [OR] 5.7 [95% CI 2.4-13.4]) and exposure to maternal obesity (2.8 [1.5-5.2]) were independently associated with type 2 diabetes. Adjustment for other perinatal and socioeconomic factors did not alter these associations. When offspring BMI was added, the OR for the association between in utero exposure to obesity and type 2 diabetes was attenuated toward the null (OR 1.1 [0.5-2.4]). Overall, 47.2% (95% CI 30.9-63.5) of type 2 diabetes in youth could be attributed to intrauterine exposure to maternal diabetes and obesity.


CONCLUSIONS
Intrauterine exposures to maternal diabetes and obesity are strongly associated with type 2 diabetes in youth. Prevention efforts may need to target, in addition to childhood obesity, the increasing number of pregnancies complicated by obesity and diabetes.
Dabelea
Dana
D
Department of Preventive Medicine and Biometrics, University of Colorado Denver, Denver, Colorado, USA. dana.dabelea@uchsc.edu
Mayer-Davis
Elizabeth J
EJ
Lamichhane
Archana P
AP
D'Agostino
Ralph B
RB
Liese
Angela D
AD
Vehik
Kendra S
KS
Narayan
K M Venkat
KM
Zeitler
Phillip
P
Hamman
Richard F
RF
D000293:Adolescent; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*