Lowe WL, et al. - In this international multiethnic cohort study, researchers analyzed impacts of gestational diabetes (GD) on maternal glucose metabolism and childhood adiposity 10 to 14 years’ postpartum. A significant association was noted between GD and a higher maternal risk for a disorder of glucose metabolism during long-term follow-up after pregnancy among women with GD identified by contemporary criteria vs those without it. The difference in childhood overweight or obesity defined by body mass index cutoffs was not statistically significant among children of mothers with GD vs those without it.

Methods

• The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study recognized a relationship between glucose levels during pregnancy and perinatal outcomes, and the follow-up study assessed long-term outcomes (4,697 mothers and 4,832 children; study visits occurred between February 13, 2013 and December 13, 2016).
• Using criteria from the International Association of Diabetes and Pregnancy Study Groups, gestational diabetes was defined post hoc by 1 or more of the following 75-g oral glucose tolerance test results (fasting plasma glucose ≥92 mg/dL; 1-hour plasma glucose level ≥180 mg/dL; 2-hour plasma glucose level ≥153 mg/dL).
• A disorder of glucose metabolism (composite of type 2 diabetes or prediabetes) was the primary maternal outcome.
• Being overweight or obese was the primary outcome for children.
• Obesity, body fat percentage, waist circumference, and sum of skinfolds (>85th percentile for latter 3 outcomes) were the included secondary outcomes.

Results

• The analytic cohort comprised 4,697 mothers (mean [SD] age, 41.7 [5.7] years) and 4,832 children (mean [SD] age, 11.4 [1.2] years; 51.0% male).
• It was noted that 11.4 years was the median duration of follow-up.
• Findings revealed that the GD criteria were met by 14.3% (672/4,697) of mothers overall and by 14.1% (683/4832) of mothers of included children.
• Data reported that 52.2% (346/663) of mothers with GD developed a disorder of glucose metabolism vs 20.1% (791/3946) of mothers without GD (odds ratio [OR], 3.44 [95% CI, 2.85 to 4.14]; risk difference [RD], 25.7% [95% CI, 21.7% to 29.7%]).
• Researchers found that among children of mothers with GD, 39.5% (269/681) were overweight or obese and 19.1% (130/681) were obese compared to 28.6% (1,172/4,094) and 9.9% (405/4,094), respectively, for children of mothers without GD.
• The OR was 1.21 (95% CI, 1.00 to 1.46) for children who were overweight or obese and the RD was 3.7% (95% CI, -0.16% to 7.5%) adjusted for maternal body mass index during pregnancy.
• In addition, the OR was 1.58 (95% CI, 1.24 to 2.01) for children who were obese, and the RD was 5.0% (95% CI, 2.0% to 8.0%).
• The OR was 1.35 (95% CI, 1.08 to 1.68) for body fat percentage and the RD was 4.2% (95% CI, 0.9% to 7.4%).
• The OR was 1.34 (95% CI, 1.08 to 1.67) for waist circumference and the RD was 4.1% (95% CI, 0.8% to 7.3%).
• The OR was 1.57 (95% CI, 1.27 to 1.95) for sum of skinfolds and the RD was 6.5% (95% CI, 3.1% to 9.9%).