title: Growth and obesity through the first 7 y of life in association with levels of maternal glycemia during pregnancy: a prospective cohort study.
abstract: BACKGROUND
  Given the long-term adverse sequelae of childhood obesity, identification of early life factors related to fetal growth and childhood obesity is warranted. Investigation on growth and obesity in early life in association with intrauterine exposure to maternal hyperglycemia, a common metabolic pregnancy complication, is of public health significance and clinical implications.
  
  
  OBJECTIVE
  We investigated the association of fasting plasma glucose (FPG) concentrations during pregnancy with offspring growth and risk of overweight/obesity through age 7 y, after adjustment for confounders, including maternal prepregnancy obesity status.
  
  
  METHODS
  FPG concentrations at 28 gestational weeks (IQR: 22-32 wk) were extracted from medical records for 661 pregnancies complicated by gestational diabetes mellitus in the Danish National Birth Cohort (1996-2002). Offspring's ponderal index was derived from birth weight and length; age- and sex-specific body mass index (BMI) z scores at 5 mo, 12 mo, and 7 y were calculated based on WHO reference data. Relations between FPG and offspring growth and obesity were assessed by linear and Poisson regression with robust standard errors, adjusting for maternal prepregnancy BMI and sociodemographic and perinatal factors.
  
  
  RESULTS
  At birth, maternal FPG during pregnancy was significantly associated with offspring ponderal index (β = 0.46; 95% CI: 0.14, 0.78 per 1-mmol/L increase) and risk of macrosomia (birth weight >4000 g) (RR = 1.21; 95% CI: 1.07, 1.38 per 1-mmol/L increase). At 7 y, higher maternal FPG concentrations were significantly associated with increased BMI z scores (β = 0.20; 95% CI: 0.04, 0.36) and elevated risk of overweight/obesity (RR = 1.21; 95% CI: 1.01, 1.50). Additional adjustment for birth weight and childhood lifestyle factors did not appreciably alter results. No associations were observed at 5 or 12 mo.
  
  
  CONCLUSIONS
  Among women with gestational diabetes mellitus, maternal FPG concentrations during pregnancy were significantly and positively associated with offspring birth size and overweight/obesity risk at 7 y, adjusting for maternal prepregnancy BMI.
authors.affiliation: From the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Rockville, MD;
authors.forename: Yeyi
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark;
authors.forename: Sjurdur F
authors.initials: SF
authors.lastname: Olsen
authors.affiliation: From the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Rockville, MD;
authors.forename: Pauline
authors.initials: P
authors.lastname: Mendola
authors.affiliation: From the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Rockville, MD;
authors.forename: Edwina H
authors.initials: EH
authors.lastname: Yeung
authors.affiliation: Department of Endocrinology and.
authors.forename: Allan
authors.initials: A
authors.lastname: Vaag
authors.affiliation: From the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Rockville, MD;
authors.forename: Katherine
authors.initials: K
authors.lastname: Bowers
authors.affiliation: From the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Rockville, MD;
authors.forename: Aiyi
authors.initials: A
authors.lastname: Liu
authors.affiliation: From the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Rockville, MD;
authors.forename: Wei
authors.initials: W
authors.lastname: Bao
authors.affiliation: From the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Rockville, MD;
authors.forename: Shanshan
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Endocrinology and.
authors.forename: Camilla
authors.initials: C
authors.lastname: Madsen
authors.affiliation: Department of Endocrinology and.
authors.forename: Louise G
authors.initials: LG
authors.lastname: Grunnet
authors.affiliation: Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark;
authors.forename: Charlotta
authors.initials: C
authors.lastname: Granström
authors.affiliation: Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark;
authors.forename: Susanne
authors.initials: S
authors.lastname: Hansen
authors.affiliation: From the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Rockville, MD;
authors.forename: Kelly
authors.initials: K
authors.lastname: Martin
authors.affiliation: Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; and.
authors.forename: Jorge E
authors.initials: JE
authors.lastname: Chavarro
authors.affiliation: Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; and.
authors.forename: Frank B
authors.initials: FB
authors.lastname: Hu
authors.affiliation: Department of Obstetrics, Rigshospitalet University Hospital, Copenhagen, Denmark;
authors.forename: Jens
authors.initials: J
authors.lastname: Langhoff-Roos
authors.affiliation: Center for Pregnant Women With Diabetes, Department of Obstetrics, Rigshospitalet, The Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Damm
authors.affiliation: From the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Rockville, MD; zhangcu@mail.nih.gov.
authors.forename: Cuilin
authors.initials: C
authors.lastname: Zhang
mesh_terms: D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism*; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D016640:Diabetes, Gestational / Q000097:blood; D005260:Female; D005320:Fetal Macrosomia / Q000209:etiology; D006128:Growth; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D050177:Overweight; D063766:Pediatric Obesity / Q000209:etiology*; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D001786:Blood Glucose
keywords: childhood obesity; fasting plasma glucose; gestational diabetes; intrauterine exposure; macrosomia; prepregnancy obesity
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