Gestational diabetes linked to obesity

Gestational diabetes may increase a child’s later risk of obesity, new research has found.

Maternal gestational diabetes (GDM) is associated with increased odds of offspring obesity at age 9 to 11 years, suggested the multinational study of more than 4,700 children, which was published online earlier this month.

The association is not fully independent of current maternal body mass index (BMI), however, the authors note.

It was observed that children born to mothers who had gestational diabetes had significantly higher prevalence of general obesity (18.4% vs 12.0%), central obesity (16.0% vs 9.6%), and high body fat (12.1% vs 7.9%) at age nine to 11 years compared with children of mothers without gestational diabetes, according to the report. These children also had significantly higher mean birth weight.

According to the authors, the mechanisms by which exposure to diabetes in the womb increases the risk of offspring obesity are not fully understood.

“Exposure to maternal diabetes is associated with excess fetal growth in utero, possibly mainly due to an increase in fetal fat mass and alterations in fetal hormone levels. In addition, exposure to maternal diabetes results in higher levels of blood sugar, insulin and leptin in offspring. Maternal prenatal GDM may also influence fetal genetics, thereby influencing the expression of genes that direct the accumulation of body fat or related metabolism,” the authors state.

The study found that the positive association was still statistically significant for central obesity after adjusting for current maternal BMI but was no longer significant for obesity and high body fat.

“Maternal GDM was associated with increased odds of childhood obesity at 9–11 years old but this association was not fully independent of maternal BMI,” concluded the authors.

Gestational diabetes mellitus is a potentially serious condition that affects many pregnancies and its prevalence is increasing. While the prevalence of gestational diabetes is generally reported as being between two per cent and six per cent, it is thought to be as high as 14 per cent in some areas.

A 2012 study found that screening practice and policy is inconsistent across Europe, and is hampered by lack of consensus on testing methods, diagnostic glycaemic thresholds and the value of routine screening. There is also poor clinician awareness of gestational diabetes, its diagnosis and local clinical guidelines which further undermine detection of the condition in pregnant women.

Photo credit: Agência Brasil Fotografias, used under the Creative Commons license.

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