Association of diabetes in pregnancy with child weight at birth, age 12 months and 5 years--a population-based electronic cohort study.
BACKGROUND
This study examines the effect of diabetes in pregnancy on offspring weight at birth and ages 1 and 5 years.


METHODS
A population-based electronic cohort study using routinely collected linked healthcare data. Electronic medical records provided maternal diabetes status and offspring weight at birth and ages 1 and 5 years (n = 147,773 mother child pairs). Logistic regression models were used to obtain odds ratios to describe the association between maternal diabetes status and offspring size, adjusted for maternal pre-pregnancy weight, age and smoking status.


RESULTS
We identified 1,250 (0.9%) pregnancies with existing diabetes (27.8% with type 1 diabetes), 1,358 with gestational diabetes (0.9%) and 635 (0.4%) who developed diabetes post-pregnancy. Children whose mothers had existing diabetes were less likely to be large at 12 months (OR: 0.7 (95%CI: 0.6, 0.8)) than those without diabetes. Maternal diabetes was associated with high weight at age 5 years in children whose mothers had a high pre-pregnancy weight tertile (gestational diabetes, (OR:2.1 (95%CI:1.25-3.6)), existing diabetes (OR:1.3 (95%CI:1.0 to 1.6)).


CONCLUSIONS
The prevention of childhood obesity should focus on mothers with diabetes with a high maternal pre-pregnancy weight. We found little evidence that diabetes in pregnancy leads to long term obesity 'programming'.
College of Medicine, Swansea University, Swansea, Wales, United Kingdom.
Kelly
K
Morgan
Mohammed
M
Rahman
Mark
M
Atkinson
Shang-Ming
SM
Zhou
Rebecca
R
Hill
Ashrafunnesa
A
Khanom
Shantini
S
Paranjothy
Sinead
S
Brophy
D001724:Birth Weight; D001835:Body Weight; D002675:Child, Preschool; D015331:Cohort Studies; D016640:Diabetes, Gestational; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016017:Odds Ratio; D063766:Pediatric Obesity / Q000453:epidemiology / Q000209:etiology; D011159:Population Surveillance; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D015430:Weight Gain