Dataset Information

Gestational diabetes and offspring's growth from birth to 6 years old.

ABSTRACT:

Objectives

The objective of this study was to compare the children's body mass index (BMI) growth between offspring exposed to maternal gestational diabetes mellitus (GDM) and those not exposed, and assess the associations between maternal hyperglycemia and their offspring's overweight risk from 1 to 6 years of age.

Methods

Using the healthcare records data from the Tianjin Maternal and Child Healthcare System, we conducted a population-based cohort study, which is composed of 27,155 mother-child pairs with all mothers undergoing GDM screening test in pregnancy.

Results

After adjustment for maternal and children's characteristics, children born to mothers with abnormal glucose (including GDM or abnormal glucose challenge test (GCT) but normal oral glucose tolerance test (OGTT) results) during pregnancy had higher mean values of Z-scores for BMI for age at 1, 2, 3, 5, and 6 years of age, in comparison with those born to mothers with normal glucose (all P values < 0.05). Moreover, maternal abnormal glucose was associated with a higher risk of childhood overweight with multivariate-adjusted hazard ratios of 1.07 (95% confidence interval (CI) 1.01-1.14), 1.09 (95% CI 1.04-1.15), 1.10 (95% CI 1.04-1.15), 1.08 (95% CI 1.03-1.14), 1.08 (95% 1.03-1.13), and 1.07 (95% 1.02-1.12) at 1-6 years of age compared with children of mothers with normal glucose.

Conclusions

Abnormal maternal glucose tolerance during pregnancy was independently associated with children's higher BMI and overweight risk from 1 to 6 years of age. Women with positive GCT results but negative OGTT can be neglected by the health system. More attention should be paid to the health of these mothers and their offspring.

SUBMITTER: Wang J

PROVIDER: S-EPMC6532057 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Publications

Gestational diabetes and offspring's growth from birth to 6 years old.

Wang Jing J Pan Lei L Liu Enqing E Liu Hongyan H Liu Jin J Wang Shuting S Guo Jia J Li Nan N Zhang Cuilin C Hu Gang G

International journal of obesity (2005) 20180904 4

<h4>Objectives</h4>The objective of this study was to compare the children's body mass index (BMI) growth between offspring exposed to maternal gestational diabetes mellitus (GDM) and those not exposed, and assess the associations between maternal hyperglycemia and their offspring's overweight risk from 1 to 6 years of age.<h4>Methods</h4>Using the healthcare records data from the Tianjin Maternal and Child Healthcare System, we conducted a population-based cohort study, which is composed of 27, ...[more]

PMID: 30181654

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Project description:ObjectiveHyperglycaemia during pregnancy is associated with cardiometabolic risks for the mother and the offspring. Mothers with gestational diabetes mellitus (GDM) have signs of subclinical atherosclerosis, including increased carotid intima-media thickness (CIMT). We assessed whether GDM is associated with increased CIMT in the offspring at birth.Design and settingMySweetHeart Cohort is a prospective cohort study conducted in Switzerland.Participants, exposure and outcome measuresThis work included pregnant women with and without GDM at 24-32 weeks of gestation and their singleton live-born offspring with data on the primary outcome of CIMT. GDM was diagnosed based on the criteria of the International Association of Diabetes and Pregnancy Study Groups. Offspring's CIMT was measured by ultrasonography after birth (range 1-19 days).ResultsData on CIMT were available for 99 offspring of women without GDM and 101 offspring of women with GDM. Maternal age ranged from 18 to 47 years. Some 16% of women with GDM and 6% of women without GDM were obese. Smoking during pregnancy was more frequent among women with GDM (18%) than among those without GDM (4%). Neonatal characteristics were comparable between the two groups. The difference in CIMT between offspring of women with and without GDM was of 0.00 mm (95% CI -0.01 to 0.01; p=0.96) and remained similar on adjustment for potential confounding factors, such as maternal prepregnancy body mass index, maternal education, smoking during pregnancy, family history of diabetes, as well as offspring's sex, age, and body surface area (0.00 mm (95% CI -0.02 to 0.01; p=0.45)).ConclusionsWe found no evidence of increased CIMT in neonates exposed to GDM. A longer-term follow-up that includes additional vascular measures, such as endothelial function or arterial stiffness, may shed further light on the cardiovascular health trajectories in children born to mothers with GDM.Trial registration numberNCT02872974; Pre-results.

Project description:BackgroundMaternal gestational diabetes mellitus (GDM) had long-term influences on the health of their children. However, the influences of GDM on the oral microbiota, which was closely related to oral and systemic health in offspring, were less documented. The present study aimed to explore the oral microbiota of neonates born to mothers with GDM is differentially colonized compared with those born to mothers without GDM, and whether any such differences persist to 1 month of age.MethodsOral samples were collected from children of mothers with (n = 20) and without GDM (n = 34) at birth and again at an average age of 1 month. The oral microbiota was characterized by 16S rRNA sequencing (V3-V4). Differences in diversity and composition according to maternal GDM status were assessed, and different metabolic functional pathways and microbial ecological networks were also analyzed.ResultsAlthough no significant differences were observed in diversity metrics between GDM and non-GDM groups (P > 0.05), we found significant differences in the taxonomic composition of oral microbiota from phylum to genus level between the two groups, with the GDM group exhibiting less abundance of Veillonella in both "Day 1" (P < 0.001) and "Day 30" (P < 0.05) phases. Metabolic pathways analysis showed that 5-aminoimidazole ribonucleotide biosynthesis and inosine-5'-phosphate biosynthesis were enriched in GDM subjects in the "Day 30" phase. Moreover, ecological network analysis revealed apparent differences between GDM and control groups, with the non-GDM group containing more high-degree nodes and microbial interactions compared with the GDM group.ConclusionMaternal GDM was associated with an altered oral microbial composition in neonates, although the distinct difference between GDM and non-GDM groups diminished in infancy. The oral microbiota functions and ecological networks differed dramatically between the two groups, highlighting the importance of maternal GDM status on initial oral microbiota in offspring.

Project description:IntroductionGestational diabetes mellitus (GDM) is a state of glucose intolerance with onset during pregnancy. GDM carries prenatal and perinatal risks as well as long-term risks for the mother and her child. GDM may be involved in the foetal programming of long-term cardiovascular health. However, evidence is sparse and the effect of GDM on cardiovascular health is unknown. To address these issues, we will conduct MySweetHeart Cohort study. The objectives are to assess the effect of GDM on offspring's cardiovascular health early in life by using surrogate markers of cardiovascular disease and atherosclerosis.Methods and analysisThis is a cohort study of 100 offspring of women with GDM and 100 offspring of women without GDM. At inclusion, a baseline assessment of the mothers will be conducted through means of self-report questionnaires, a researcher-administrated interview, blood pressure and anthropometric measurements, and a maternal blood sampling. Between the 30th and 34th weeks of gestation, a foetal echography will be performed to assess the foetal cardiac structure and function, the fetomaternal circulation and the hepatic volume. At birth, maternal and neonatal characteristics will be assessed. An echocardiography will be performed to assess cardiac structure and function 2-7 days after birth; carotid intima-media thickness will be also measured to assess vascular structure. MySweetHeart Cohort is linked to MySweetHeart Trial (clinicaltrials.gov/ct2/show/NCT02890693), a randomised controlled trial assessing the effect of a multidimensional interdisciplinary lifestyle and psychosocial intervention to improve the cardiometabolic and mental health of women with GDM and their offspring. A long-term follow-up of children is planned.Ethics and disseminationEthical approval has been obtained through the state Human Research Ethics Committee of the Canton de Vaud (study number 2016-00745). We aim to disseminate the findings through regional, national and international conferences and through peer-reviewed journals.Trial registration numberClinicalTrials.gov (clinicaltrials.gov/ct2/show/NCT02872974).

Project description:Maternal vitamin D status has been associated with both gestational diabetes mellitus (GDM) and fetal growth restriction, however, the evidence is inconsistent. In Finland, maternal vitamin D status has improved considerably due to national health policies. Our objective was to compare maternal 25-hydroxy vitamin D concentrations [25(OH)D] between mothers with and without GDM, and to investigate if an association existed between maternal vitamin D concentration and infant birth size.This cross-sectional study included 723 mother-child pairs. Mothers were of Caucasian origin, and infants were born at term with normal birth weight. GDM diagnosis and birth size were obtained from medical records. Maternal 25(OH)D was determined on average at 11 weeks of gestation in pregnancy and in umbilical cord blood (UCB) at birth.GDM was observed in 81 of the 723 women (11%). Of the study population, 97% were vitamin D sufficient [25(OH)D???50 nmol/L]. There was no difference in pregnancy 25(OH)D concentration between GDM and non-GDM mothers (82 vs 82 nmol/L, P?=?0.99). Regression analysis confirmed no association between oral glucose tolerance test results and maternal 25(OH)D (P?>?0.53). Regarding the birth size, mothers with optimal pregnancy 25(OH)D (? 80 nmol/L) had heavier newborns than those with suboptimal pregnancy 25(OH)D (P?=?0.010). However, mothers with optimal UCB 25(OH)D had newborns with smaller head circumference than those with suboptimal 25(OH)D (P?=?0.003), which was further confirmed as a linear association (P?=?0.024).Maternal vitamin D concentration was similar in mothers with and without GDM in a mostly vitamin D sufficient population. Associations between maternal vitamin D status and birth size were inconsistent. A sufficient maternal vitamin D status, specified as 25(OH)D above 50 nmol/L, may be a threshold above which the physiological requirements of pregnancy are achieved.The project protocol is registered in ClinicalTrials.gov in November 8, 2012 ( NCT01723852 ).

Dataset Information

Gestational diabetes and offspring's growth from birth to 6 years old.

Objectives

Methods

Results

Conclusions

Publications

Gestational diabetes and offspring's growth from birth to 6 years old.

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