A GROUNDBREAKING study conducted in Manitoba, Canada, has shed light on the impact of maternal diabetes on offspring fracture risk. Led by Viral N. Shah, Indiana University School of Medicine, Indianapolis, USA, this research highlights the crucial role of the intrauterine environment in shaping skeletal health and fracture susceptibility later in life.
Diabetes during pregnancy is already known to influence birth weight and fetal growth, but its effects on offspring fracture risk have remained unclear until now. By analysing population-based administrative health data spanning four decades, the researchers identified deliveries complicated by gestational diabetes and Type 2 diabetes.
The cohort, comprising 585,176 deliveries, was followed for a median of 15.8 years, allowing for a comprehensive assessment of fracture outcomes. The primary outcome of the study was any incident fracture in offspring, with secondary outcomes including specific fracture types, such as long bone upper extremity fracture, long bone lower extremity fracture, vertebral fracture, and any non-trauma fractures.
Cox proportional hazard regression models were utilised to estimate fracture risk in offspring by maternal diabetes status, adjusted for relevant covariates. The results revealed a significant association between maternal diabetes and increased fracture risk in offspring. Offspring born to mothers with diabetes showed a 7% higher adjusted risk for any fracture, compared to those born to mothers without diabetes. Importantly, the types of fractures observed were similar between the two groups, with a predominance of long bone upper extremity fractures. This finding underscores the need for further research to elucidate the underlying mechanisms driving this association.
In conclusion, maternal diabetes was found to be associated with a modest but notable increase in fracture risk in offspring. The study highlights the importance of understanding intrauterine and postnatal factors that may influence skeletal health, paving the way for future longitudinal prospective studies in this field.
Reference
Shah AN et al. Maternal diabetes and fracture risk in offspring: a population-based analysis. J Bone Miner Res. 2024;DOI:10.1093/jbmr/zjae052.
