Effect of treatment of gestational diabetes mellitus on obesity in the next generation.
OBJECTIVE
Gestational diabetes mellitus (GDM) may cause obesity in the offspring. The objective was to assess the effect of treatment for mild GDM on the BMI of 4- to 5-year-old children.


METHODS
Participants were 199 mothers who participated in a randomized controlled trial of the treatment of mild GDM during pregnancy and their children. Trained nurses measured the height and weight of the children at preschool visits in a state-wide surveillance program in the state of South Australia. The main outcome measure was age- and sex-specific BMI Z score based on standards of the International Obesity Task Force.


RESULTS
At birth, prevalence of macrosomia (birth weight >or=4,000 g) was 5.3% among the 94 children whose mothers were in the intervention group, and 21.9% among the 105 children in the routine care control group. At 4- to 5-years-old, mean (SD) BMI Z score was 0.49 (1.20) in intervention children and 0.41 (1.40) among controls. The difference between treatment groups was 0.08 (95% CI -0.29 to 0.44), an estimate minimally changed by adjustment for maternal race, parity, age, and socio-economic index (0.08 [-0.29 to 0.45]). Evaluating BMI >or=85th percentile rather than continuous BMI Z score gave similarly null results.


CONCLUSIONS
Although treatment of GDM substantially reduced macrosomia at birth, it did not result in a change in BMI at age 4- to 5-years-old.
Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA. matthew_gillman@hms.harvard.edu
Matthew W
MW
Gillman
Helena
H
Oakey
Peter A
PA
Baghurst
Robert E
RE
Volkmer
Jeffrey S
JS
Robinson
Caroline A
CA
Crowther
D015992:Body Mass Index; D002675:Child, Preschool; D016640:Diabetes, Gestational / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology / Q000517:prevention & control; D005500:Follow-Up Studies; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000008:administration & dosage*; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology; D015995:Prevalence; D013021:South Australia / Q000453:epidemiology
D007004:Hypoglycemic Agents; D007328:Insulin