title: Development of Early Adiposity in Infants of Mothers With Gestational Diabetes Mellitus.
abstract: Infants born to mothers with gestational diabetes mellitus (GDM) are at greater risk of later adverse metabolic health. We examined plausible candidate mediators, adipose tissue (AT) quantity and distribution and intrahepatocellular lipid (IHCL) content, comparing infants of mothers with GDM and without GDM (control group) over the first 3 postnatal months.
  
  
  
  We conducted a prospective longitudinal study using MRI and spectroscopy to quantify whole-body and regional AT volumes, and IHCL content, within 2 weeks and 8-12 weeks after birth. We adjusted for infant size and sex and maternal prepregnancy BMI. Values are reported as the mean difference (95% CI).
  
  
  
  We recruited 86 infants (GDM group 42 infants; control group 44 infants). Mothers with GDM had good pregnancy glycemic control. Infants were predominantly breast-fed up to the time of the second assessment (GDM group 71%; control group 74%). Total AT volumes were similar in the GDM group compared with the control group at a median age of 11 days (-28 cm(3) [95% CI -121, 65], P = 0.55), but were greater in the GDM group at a median age of 10 weeks (247 cm(3) [56, 439], P = 0.01). After adjustment for size, the GDM group had significantly greater total AT volume at 10 weeks than control group infants (16.0% [6.0, 27.1], P = 0.002). AT distribution and IHCL content were not significantly different at either time point.
  
  
  
  Adiposity in GDM infants is amplified in early infancy, despite good maternal glycemic control and predominant breast-feeding, suggesting a potential causal pathway to later adverse metabolic health. Reduction in postnatal adiposity may be a therapeutic target to reduce later health risks.
authors.affiliation: Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, U.K. k.logan@imperial.ac.uk.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Logan
authors.affiliation: Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, U.K.
authors.forename: Robby J
authors.initials: RJ
authors.lastname: Emsley
authors.affiliation: Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, U.K.
authors.forename: Suzan
authors.initials: S
authors.lastname: Jeffries
authors.affiliation: Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, U.K.
authors.forename: Izabela
authors.initials: I
authors.lastname: Andrzejewska
authors.affiliation: Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, U.K.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Hyde
authors.affiliation: Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, U.K.
authors.forename: Chris
authors.initials: C
authors.lastname: Gale
authors.affiliation: Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, U.K.
authors.forename: Karyn
authors.initials: K
authors.lastname: Chappell
authors.affiliation: Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, U.K.
authors.forename: Sundhiya
authors.initials: S
authors.lastname: Mandalia
authors.affiliation: Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, U.K.
authors.forename: Shalini
authors.initials: S
authors.lastname: Santhakumaran
authors.affiliation: Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, U.K.
authors.forename: James R C
authors.initials: JR
authors.lastname: Parkinson
authors.affiliation: Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, U.K.
authors.forename: Luke
authors.initials: L
authors.lastname: Mills
authors.affiliation: Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, U.K.
authors.forename: Neena
authors.initials: N
authors.lastname: Modi
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging* / Q000378:metabolism; D050154:Adiposity; D001942:Breast Feeding; D016022:Case-Control Studies; D016640:Diabetes, Gestational; D005260:Female; D006801:Humans; D007223:Infant; D050356:Lipid Metabolism; D008099:Liver / Q000000981:diagnostic imaging* / Q000378:metabolism; D008137:Longitudinal Studies; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011446:Prospective Studies