The impact of in utero exposure to diabetes on childhood body mass index growth trajectories: the EPOCH study.
OBJECTIVE
To examine associations between exposure to maternal diabetes in utero and body mass index (BMI) growth trajectories from birth through 13 years of age among a diverse cohort of youth.


METHODS
Mixed linear effects models were constructed to assess differences in BMI and BMI growth velocity from birth through 13 years of age for 95 subjects exposed to diabetes in utero and 409 unexposed subjects enrolled in a retrospective cohort study.


RESULTS
The overall BMI growth trajectory (adjusted for sex and race/ethnicity) was not significantly different for exposed and unexposed subjects from birth through 26 months of age (P = .48). However, the overall growth trajectory from 27 months of age through 13 years differed by exposure status (P = .008), adjusted for sex and race/ethnicity. The difference was primarily due to a significantly higher BMI growth velocity among exposed youth between 10 and 13 years, increasing by 4.56 kg/m² compared with 3.51 kg/m² in the unexposed (P = .005). Control for demographic variables, socioeconomic factors, and maternal prepregnancy BMI did not alter the observed associations.


CONCLUSIONS
Exposure to maternal diabetes in utero accelerates BMI growth in late childhood, thus increasing long-term obesity risk.
Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, CO, USA.
Tessa L
TL
Crume
Lorraine
L
Ogden
Stephen
S
Daniels
Richard F
RF
Hamman
Jill M
JM
Norris
Dana
D
Dabelea
D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000503:physiopathology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D018811:Maternal Exposure; D009765:Obesity / Q000150:complications / Q000209:etiology*; D011247:Pregnancy; D012189:Retrospective Studies; D013997:Time Factors
Diabetes. 1985 Jun;34 Suppl 2:119-22
3996763
Diabetes Care. 2005 Mar;28(3):585-9
15735192
Diabetes. 1980 Dec;29(12):1023-35
7002669
J Clin Endocrinol Metab. 1992 Aug;75(2):442-6
1639945
N Engl J Med. 1998 Jun 4;338(23):1650-6
9614255
Pediatrics. 2005 May;115(5):1367-77
15867049
Pediatrics. 2003 Mar;111(3):e221-6
12612275
Annu Rev Med. 1968;19:283-300
4297619
N Engl J Med. 1992 Nov 5;327(19):1350-5
1406836
Obstet Gynecol Clin North Am. 2009 Jun;36(2):361-77, ix-x
19501319
Obstet Gynecol. 2008 Nov;112(5):999-1006
18978098
Diabetes. 2000 Dec;49(12):2208-11
11118027
Pediatrics. 2005 Dec;116(6):1329-38
16322155
Int J Epidemiol. 2001 Dec;30(6):1332-41
11821342
J Matern Fetal Med. 2000 Jan-Feb;9(1):83-8
10757442
Diabetes Care. 1993 Jan;16(1):310-4
8422798
Am J Hypertens. 2009 Feb;22(2):215-20
19023272
Lancet. 2005 Oct 1;366(9492):1197-209
16198769
Diabetes. 1991 Dec;40 Suppl 2:121-5
1748240
Obstet Gynecol. 2001 May;97(5 Pt 1):776-80
11339933
Lancet. 2002 Aug 10;360(9331):473-82
12241736
Am J Obstet Gynecol. 2003 Dec;189(6):1698-704
14710101
Diabetes. 1979 Dec;28(12):1039-57
510803
Med Clin North Am. 1953 Sep;1:1481-96
13086033
N Engl J Med. 1983 Feb 3;308(5):242-5
6848933
Int J Obes Relat Metab Disord. 2003 Feb;27(2):162-72
12586995
Am J Clin Nutr. 1984 Jan;39(1):129-35
6691287
Diabetes Care. 2010 May;33(5):964-8
20150300
Ann Hum Biol. 1987 May-Jun;14(3):219-29
3662424