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Reduced size at birth and persisting reductions in adiposity in recent, compared with earlier, cohorts of infants born to mothers with gestational diabetes mellitus.
Diabetologia. 2019 11; 62(11):1977-1987.D

Abstract

AIMS/HYPOTHESIS

This study aimed to explore the infancy growth trajectories of 'recent' and 'earlier' offspring of mothers with gestational diabetes mellitus (OGDM), each compared with the same control infants, and investigate whether 'recent' OGDM still exhibit a classical phenotype, with macrosomia and increased adiposity.

METHODS

Within a prospective observational birth cohort, 98 'earlier' OGDM born between 2001 and 2009 were identified using 75 g oral glucose tolerance testing at 28 weeks gestation, 122 recent OGDM born between 2011 and 2013 were recruited postnatally through antenatal diabetes clinics, and 876 normal birthweight infants of mothers with no history of diabetes were recruited across the full study period as the control group. All infants followed the same study protocol (measurements at birth, 3, 12 and 24 months, including weight, length and skinfold thickness indicating adiposity, and detailed demographic data). In all cases, GDM was defined using the International Association of Diabetes and Pregnancy Study Group criteria.

RESULTS

Earlier OGDM had higher birthweight SD scores (SDS) than control infants. Conversely, recent OGDM had similar birthweight- and length SDS to control infants (mean ± SD, 0.1 ± 1.0 and- 0.1 ± 0.9, respectively), but lower mean skinfold thickness SDS (-0.4 ± 0.6 vs 0.0 ± 0.9; p < 0.001). After birth, earlier OGDM showed reduced gains in weight and length between 3 and 12 months. In contrast, recent OGDM had increased weight and skinfold thickness gains until 3 months, followed by reduced gains in those variables from 3 to 12 months, compared with control infants. At 24 months, recent OGDM had lower adiposity than control infants (mean skinfold thickness SDS -0.3 ± 0.7 vs 0.0 ± 0.8; p < 0.001). At all time points recent OGDM had lower growth measurements than earlier OGDM.

CONCLUSIONS/INTERPRETATION

Recent OGDM showed different growth trajectories to the earlier group, namely normalisation of birthweight and reduced adiposity at birth, followed by initial rapid weight gain but subsequent reduced adiposity postnatally. While avoidance of macrosomia at birth may be advantageous, the longer-term health implications of these changing growth trajectories are uncertain.

Authors+Show Affiliations

Department of Paediatrics, University of Cambridge, Box 116, Level 8, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK. Department of Paediatrics, North Middlesex University Hospital NHS Trust, London, UK.Department of Paediatrics, University of Cambridge, Box 116, Level 8, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.Department of Paediatrics, University of Cambridge, Box 116, Level 8, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.Wolfson Diabetes and Endocrine Clinic, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. Macarthur Clinical School, Western Sydney University, Sydney, NSW, Australia.Wolfson Diabetes and Endocrine Clinic, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. Department of Diabetes and Endocrinology, Norfolk and Norwich University Hospital, Norwich, UK. Women's Health Academic Centre, Division of Women's and Children's Health, King's College London, London, UK.Department of Paediatrics, University of Cambridge, Box 116, Level 8, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.Department of Paediatrics, University of Cambridge, Box 116, Level 8, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.Department of Paediatrics, University of Cambridge, Box 116, Level 8, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK. MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge, UK. Institute of Metabolic Science, University of Cambridge, Cambridge, UK.Department of Paediatrics, University of Cambridge, Box 116, Level 8, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK. dbd25@cam.ac.uk. Institute of Metabolic Science, University of Cambridge, Cambridge, UK. dbd25@cam.ac.uk.

Pub Type(s)

Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31396660

Citation

Prentice, Philippa M., et al. "Reduced Size at Birth and Persisting Reductions in Adiposity in Recent, Compared With Earlier, Cohorts of Infants Born to Mothers With Gestational Diabetes Mellitus." Diabetologia, vol. 62, no. 11, 2019, pp. 1977-1987.
Prentice PM, Olga L, Petry CJ, et al. Reduced size at birth and persisting reductions in adiposity in recent, compared with earlier, cohorts of infants born to mothers with gestational diabetes mellitus. Diabetologia. 2019;62(11):1977-1987.
Prentice, P. M., Olga, L., Petry, C. J., Simmons, D., Murphy, H. R., Hughes, I. A., Acerini, C. L., Ong, K. K., & Dunger, D. B. (2019). Reduced size at birth and persisting reductions in adiposity in recent, compared with earlier, cohorts of infants born to mothers with gestational diabetes mellitus. Diabetologia, 62(11), 1977-1987. https://doi.org/10.1007/s00125-019-4970-6
Prentice PM, et al. Reduced Size at Birth and Persisting Reductions in Adiposity in Recent, Compared With Earlier, Cohorts of Infants Born to Mothers With Gestational Diabetes Mellitus. Diabetologia. 2019;62(11):1977-1987. PubMed PMID: 31396660.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reduced size at birth and persisting reductions in adiposity in recent, compared with earlier, cohorts of infants born to mothers with gestational diabetes mellitus. AU - Prentice,Philippa M, AU - Olga,Laurentya, AU - Petry,Clive J, AU - Simmons,David, AU - Murphy,Helen R, AU - Hughes,Ieuan A, AU - Acerini,Carlo L, AU - Ong,Ken K, AU - Dunger,David B, Y1 - 2019/08/09/ PY - 2019/01/24/received PY - 2019/06/27/accepted PY - 2019/8/10/pubmed PY - 2020/7/10/medline PY - 2019/8/10/entrez KW - Adiposity KW - Gestational diabetes mellitus KW - Growth KW - Infancy KW - Macrosomia KW - Maternal hyperglycaemia KW - Offspring KW - Skinfold thickness KW - Weight gain SP - 1977 EP - 1987 JF - Diabetologia JO - Diabetologia VL - 62 IS - 11 N2 - AIMS/HYPOTHESIS: This study aimed to explore the infancy growth trajectories of 'recent' and 'earlier' offspring of mothers with gestational diabetes mellitus (OGDM), each compared with the same control infants, and investigate whether 'recent' OGDM still exhibit a classical phenotype, with macrosomia and increased adiposity. METHODS: Within a prospective observational birth cohort, 98 'earlier' OGDM born between 2001 and 2009 were identified using 75 g oral glucose tolerance testing at 28 weeks gestation, 122 recent OGDM born between 2011 and 2013 were recruited postnatally through antenatal diabetes clinics, and 876 normal birthweight infants of mothers with no history of diabetes were recruited across the full study period as the control group. All infants followed the same study protocol (measurements at birth, 3, 12 and 24 months, including weight, length and skinfold thickness indicating adiposity, and detailed demographic data). In all cases, GDM was defined using the International Association of Diabetes and Pregnancy Study Group criteria. RESULTS: Earlier OGDM had higher birthweight SD scores (SDS) than control infants. Conversely, recent OGDM had similar birthweight- and length SDS to control infants (mean ± SD, 0.1 ± 1.0 and- 0.1 ± 0.9, respectively), but lower mean skinfold thickness SDS (-0.4 ± 0.6 vs 0.0 ± 0.9; p < 0.001). After birth, earlier OGDM showed reduced gains in weight and length between 3 and 12 months. In contrast, recent OGDM had increased weight and skinfold thickness gains until 3 months, followed by reduced gains in those variables from 3 to 12 months, compared with control infants. At 24 months, recent OGDM had lower adiposity than control infants (mean skinfold thickness SDS -0.3 ± 0.7 vs 0.0 ± 0.8; p < 0.001). At all time points recent OGDM had lower growth measurements than earlier OGDM. CONCLUSIONS/INTERPRETATION: Recent OGDM showed different growth trajectories to the earlier group, namely normalisation of birthweight and reduced adiposity at birth, followed by initial rapid weight gain but subsequent reduced adiposity postnatally. While avoidance of macrosomia at birth may be advantageous, the longer-term health implications of these changing growth trajectories are uncertain. SN - 1432-0428 UR - https://www.unboundmedicine.com/medline/citation/31396660/Reduced_size_at_birth_and_persisting_reductions_in_adiposity_in_recent_compared_with_earlier_cohorts_of_infants_born_to_mothers_with_gestational_diabetes_mellitus_ L2 - https://doi.org/10.1007/s00125-019-4970-6 DB - PRIME DP - Unbound Medicine ER -