title: Gestational diabetes and subsequent growth patterns of offspring: the National Collaborative Perinatal Project.
abstract: Our objective was to test the hypothesis that intrauterine exposure to gestational diabetes [GDM] predicts childhood growth independent of the effect on infant birthweight. We conducted a prospective analysis of 28,358 mother-infant pairs who enrolled in the National Collaborative Perinatal Project between 1959 and 1965. The offspring were followed until age 7. Four hundred and eighty-four mothers (1.7%) had GDM. The mean birthweight was 3.2 kg (range 1.1-5.6 kg). Maternal characteristics (age, education, race, family income, pre-pregnancy body mass index and pregnancy weight gain) and measures of childhood growth (birthweight, weight at ages 4, and 7) differed significantly by GDM status (all P < 0.05). As expected, compared to their non-diabetic counterparts, mothers with GDM gave birth to offspring that had higher weights at birth. The offspring of mothers with GDM were larger at age 7 as indicated by greater weight, BMI and BMI z-score compared to the offspring of mothers without GDM at that age (all P < 0.05). These differences at age 7 persisted even after adjustment for infant birthweight. Furthermore, the offspring of mothers with GDM had a 61% higher odds of being overweight at age 7 compared to the offspring of mothers without GDM after adjustment for maternal BMI, pregnancy weight gain, family income, race and birthweight [OR = 1.61 (95%CI:1.07, 1.28)]. Our results indicate that maternal GDM status is associated with offspring overweight status during childhood. This relationship is only partially mediated by effects on birthweight.
authors.affiliation: School of Nursing, Penn State University, University Park, Hershey, PA 17033, USA. kab50@psu.edu
authors.forename: Kesha
authors.initials: K
authors.lastname: Baptiste-Roberts
authors.forename: Wanda K
authors.initials: WK
authors.lastname: Nicholson
authors.forename: Nae-Yuh
authors.initials: NY
authors.lastname: Wang
authors.forename: Frederick L
authors.initials: FL
authors.lastname: Brancati
mesh_terms: D000328:Adult; D001724:Birth Weight; D015992:Body Mass Index; D001835:Body Weight; D002657:Child Development / Q000502:physiology; D016640:Diabetes, Gestational / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology* / Q000503:physiopathology; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D009035:Mothers; D009765:Obesity / Q000453:epidemiology / Q000503:physiopathology*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000503:physiopathology*; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult