RECENT findings have demonstrated a connection between gestational diabetes mellitus (GDM) in mothers and the increased risk of their children being overweight, mediated by higher fetal growth rates. Gestational diabetes, a condition characterised by high blood glucose levels during pregnancy, is known to result in higher birthweights and an increased likelihood of children becoming overweight during their childhood. Prior studies have already established that children born to mothers with GDM or who are overweight themselves face a heightened risk of obesity in adolescence and adulthood. However, the precise mechanisms driving this intergenerational transmission of overweight risk remain unclear. The researchers aimed to compare fetal growth rates in pregnancies affected by GDM with those in pregnancies exhibiting normal glucose tolerance and to determine if this increased growth rate could explain the elevated risk of being overweight in offspring.
The researchers analysed fetal biometrics and childhood weight records using data from Aarhus University Hospital and Aarhus Municipality Healthcare Service. The longitudinal cohort looked at children born between 2008 and 2014. They calculated growth trajectories for fetuses from 6794 mother-child pairs, including 295 pairs where the mother had GDM. The analysis employed cubic mixed model regression to estimate individual fetal growth rates and assess their impact on childhood overweight risk in children aged 5 to 9 years.
The results demonstrated that from the 25th week of pregnancy, fetal growth was significantly higher in women with GDM. Offspring of these women were found to have more than double the risk of being overweight compared to those of mothers with normal glucose levels (odds ratio, 2.02 [95% CI, 1.44-2.84]). When adjustments were made for fetal growth rate at 28 weeks, this effect decreased by 15%, and further adjusting for the mother’s prepregnancy body mass index reduced the odds ratio to 1.10 (95% CI, 0.76-1.60).
The study authors concluded that pregnancies affected by GDM result in higher fetal growth rates, which partly mediate the increased risk of childhood overweight. The findings underscore the importance of monitoring and managing fetal growth in pregnancies complicated by GDM and suggest that maternal prepregnancy body mass index also plays a crucial role in determining long-term health outcomes for offspring.
Laith Gergi, EMJ
Reference:
Leth-Møller M et al. Effect of gestational diabetes on fetal growth rate and later overweight in the offspring. J Clin Endocrinol Metab. 2024;dgae428.
