Tags

Type your tag names separated by a space and hit enter

Long-term BMI and growth profiles in offspring of women with gestational diabetes.
Diabetologia. 2018 05; 61(5):1037-1045.D

Abstract

AIMS/HYPOTHESIS

Gestational diabetes mellitus (GDM) is reported to be associated with childhood obesity, however the magnitude of this association and relation to intrauterine growth is uncertain. We, therefore, aimed to assess whether the growth trajectories of large for gestational age (LGA) and non-LGA offspring of mothers with GDM (OGDM) are different until early adolescence. We also aimed to explore whether growth trajectories of OGDM differ from those of offspring of mothers with type 1 or 2 diabetes (ODM1, ODM2).

METHODS

We studied height and BMI standard deviation score (SDS) of the OGDM group, up to the age of 14 years, with subgroup analysis comparing LGA with non-LGA at birth as a reflection of the intrauterine environment. All mothers with GDM who delivered at the University Medical Center Utrecht between 1990 and 2006 were contacted to participate; informed consent was received for 104 OGDM of 93 mothers. Offspring data were collected through Dutch infant welfare centres. Recorded height and weight were converted to BMI and age- and sex-specific SDS values for Dutch children. Additionally, we compared the OGDM group with ODM1 and ODM2 groups in order to identify those offspring with the highest risk of becoming overweight. Growth trajectories were compared between non-LGA and LGA OGDM and between OGDM, ODM1 and ODM2, using a random-effects model. In the longitudinal follow-up a mean of 7.4 ± 2 measurements per infant were available.

RESULTS

Mothers had a prepregnancy BMI of 25.8 kg/m2 and 24% of their infants were LGA at birth. Heights of OGDM were no different from those of the Dutch Growth Study. Non-LGA OGDM showed a BMI SDS comparable with that of the reference population, with a slight increase in early adolescence. LGA OGDM had a higher BMI SDS trajectory than non-LGA OGDM and the reference population, which plateaued at around 10 years of age. Comparison of growth trajectories of OGDM, ODM1 and ODM2 showed ODM2 to have the highest trajectory followed by ODM1 and OGDM, with the LGA counterparts of all three offspring groups in the highest BMI SDS ranges.

CONCLUSIONS/INTERPRETATION

Until early adolescence, OGDM have a BMI that is 0.5 SDS higher than that of the Dutch background population. LGA OGDM appear to be at particularly higher risk of being overweight in adolescence compared with non-LGA OGDM, putting them also at a higher lifetime risk of being overweight and developing obesity. ODM2 showed the highest BMI SDS values and had an average BMI SDS of +1.6 until the age of 14, when it became +2 SD. These results emphasize the importance of adequate recognition and timely treatment of maternal gestational diabetes to prevent fetal macrosomia in obstetrics.

Authors+Show Affiliations

Department of Obstetrics, Division Woman & Baby, the University Medical Center Utrecht, Heidelberglaan 100, Huispostnummer KE.04.123.1, P.O. Box 85090, 3508 AB, Utrecht, the Netherlands. nurahhammoud@gmail.com. Department of Internal Medicine and Infectious Diseases, the University Medical Center Utrecht, Utrecht, the Netherlands. nurahhammoud@gmail.com.Department of Obstetrics, Division Woman & Baby, the University Medical Center Utrecht, Heidelberglaan 100, Huispostnummer KE.04.123.1, P.O. Box 85090, 3508 AB, Utrecht, the Netherlands.Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.Department of Internal Medicine and Infectious Diseases, the University Medical Center Utrecht, Utrecht, the Netherlands.Department of Pediatrics, Leiden University Medical Center, Leiden, the Netherlands.Department of Internal Medicine and Infectious Diseases, the University Medical Center Utrecht, Utrecht, the Netherlands.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29492638

Citation

Hammoud, Nurah M., et al. "Long-term BMI and Growth Profiles in Offspring of Women With Gestational Diabetes." Diabetologia, vol. 61, no. 5, 2018, pp. 1037-1045.
Hammoud NM, Visser GHA, van Rossem L, et al. Long-term BMI and growth profiles in offspring of women with gestational diabetes. Diabetologia. 2018;61(5):1037-1045.
Hammoud, N. M., Visser, G. H. A., van Rossem, L., Biesma, D. H., Wit, J. M., & de Valk, H. W. (2018). Long-term BMI and growth profiles in offspring of women with gestational diabetes. Diabetologia, 61(5), 1037-1045. https://doi.org/10.1007/s00125-018-4584-4
Hammoud NM, et al. Long-term BMI and Growth Profiles in Offspring of Women With Gestational Diabetes. Diabetologia. 2018;61(5):1037-1045. PubMed PMID: 29492638.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term BMI and growth profiles in offspring of women with gestational diabetes. AU - Hammoud,Nurah M, AU - Visser,Gerard H A, AU - van Rossem,Lenie, AU - Biesma,Douwe H, AU - Wit,Jan M, AU - de Valk,Harold W, Y1 - 2018/02/28/ PY - 2017/11/22/received PY - 2018/01/02/accepted PY - 2018/3/2/pubmed PY - 2019/1/29/medline PY - 2018/3/2/entrez KW - Body mass index KW - Childhood obesity KW - Diabetic pregnancy KW - Gestational diabetes mellitus KW - Growth trajectories KW - Longitudinal follow-up KW - Obstetrics KW - Offspring SP - 1037 EP - 1045 JF - Diabetologia JO - Diabetologia VL - 61 IS - 5 N2 - AIMS/HYPOTHESIS: Gestational diabetes mellitus (GDM) is reported to be associated with childhood obesity, however the magnitude of this association and relation to intrauterine growth is uncertain. We, therefore, aimed to assess whether the growth trajectories of large for gestational age (LGA) and non-LGA offspring of mothers with GDM (OGDM) are different until early adolescence. We also aimed to explore whether growth trajectories of OGDM differ from those of offspring of mothers with type 1 or 2 diabetes (ODM1, ODM2). METHODS: We studied height and BMI standard deviation score (SDS) of the OGDM group, up to the age of 14 years, with subgroup analysis comparing LGA with non-LGA at birth as a reflection of the intrauterine environment. All mothers with GDM who delivered at the University Medical Center Utrecht between 1990 and 2006 were contacted to participate; informed consent was received for 104 OGDM of 93 mothers. Offspring data were collected through Dutch infant welfare centres. Recorded height and weight were converted to BMI and age- and sex-specific SDS values for Dutch children. Additionally, we compared the OGDM group with ODM1 and ODM2 groups in order to identify those offspring with the highest risk of becoming overweight. Growth trajectories were compared between non-LGA and LGA OGDM and between OGDM, ODM1 and ODM2, using a random-effects model. In the longitudinal follow-up a mean of 7.4 ± 2 measurements per infant were available. RESULTS: Mothers had a prepregnancy BMI of 25.8 kg/m2 and 24% of their infants were LGA at birth. Heights of OGDM were no different from those of the Dutch Growth Study. Non-LGA OGDM showed a BMI SDS comparable with that of the reference population, with a slight increase in early adolescence. LGA OGDM had a higher BMI SDS trajectory than non-LGA OGDM and the reference population, which plateaued at around 10 years of age. Comparison of growth trajectories of OGDM, ODM1 and ODM2 showed ODM2 to have the highest trajectory followed by ODM1 and OGDM, with the LGA counterparts of all three offspring groups in the highest BMI SDS ranges. CONCLUSIONS/INTERPRETATION: Until early adolescence, OGDM have a BMI that is 0.5 SDS higher than that of the Dutch background population. LGA OGDM appear to be at particularly higher risk of being overweight in adolescence compared with non-LGA OGDM, putting them also at a higher lifetime risk of being overweight and developing obesity. ODM2 showed the highest BMI SDS values and had an average BMI SDS of +1.6 until the age of 14, when it became +2 SD. These results emphasize the importance of adequate recognition and timely treatment of maternal gestational diabetes to prevent fetal macrosomia in obstetrics. SN - 1432-0428 UR - https://www.unboundmedicine.com/medline/citation/29492638/Long_term_BMI_and_growth_profiles_in_offspring_of_women_with_gestational_diabetes_ L2 - https://doi.org/10.1007/s00125-018-4584-4 DB - PRIME DP - Unbound Medicine ER -