Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-30T19:43:53.498Z Has data issue: false hasContentIssue false

Maternal gestational diabetes mellitus and overweight and obesity in offspring: a study in Chinese children

Published online by Cambridge University Press:  26 October 2015

Y. L. Zhao
Affiliation:
Department of Obstetrics and Gynecology, First Affiliated Hospital of Kunming Medical University, Kunming, P.R. China
R. M. Ma*
Affiliation:
Department of Obstetrics and Gynecology, First Affiliated Hospital of Kunming Medical University, Kunming, P.R. China
T. T. Lao
Affiliation:
Department of Obstetrics and Gynecology, Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, P.R. China
Z. Chen
Affiliation:
Department of Obstetrics and Gynecology, First Affiliated Hospital of Kunming Medical University, Kunming, P.R. China
M. Y. Du
Affiliation:
Department of Obstetrics and Gynecology, First Affiliated Hospital of Kunming Medical University, Kunming, P.R. China
K. Liang
Affiliation:
Department of Pediatrics, First Affiliated Hospital of Kunming Medical University, Kunming, P.R. China
Y. K. Huang
Affiliation:
Department of Pediatrics, First Affiliated Hospital of Kunming Medical University, Kunming, P.R. China
L. Zhang
Affiliation:
Department of Obstetrics and Gynecology, First Affiliated Hospital of Kunming Medical University, Kunming, P.R. China
M. H. Yang
Affiliation:
Department of Obstetrics and Gynecology, First Affiliated Hospital of Kunming Medical University, Kunming, P.R. China
Y. H. Sun
Affiliation:
Department of Obstetrics and Gynecology, First Affiliated Hospital of Kunming Medical University, Kunming, P.R. China
H. Li
Affiliation:
Department of Obstetrics and Gynecology, First Affiliated Hospital of Kunming Medical University, Kunming, P.R. China
Z. B. Ding
Affiliation:
Department of Pediatrics, First Affiliated Hospital of Kunming Medical University, Kunming, P.R. China
*
*Address for Correspondence: R. M. Ma, Department of Obstetrics and Gynecology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032 P.R. China. (Email [email protected])

Abstract

The purpose of this study was to investigate the effects of maternal gestational diabetes mellitus (GDM) and breast feeding on childhood overweight and obesity in a mainland Chinese population. The incidence of and factors associated with overweight and obesity were compared between children of mothers with (n=1068) and without (n=1756) GDM. The independent roles of the associated factors were examined by multiple logistic regression analysis. The incidence of overweight was higher (16.6 v. 12.6%, P=0.002) in the GDM group, but that of obesity was not different (10.7 v. 12.0%, P=0.315). At age 1–2 and 2–5 years, no difference in overweight (11.0 v. 12.0%, P=0.917, and 15.7 v. 14.6%, P=0.693, respectively) was found, while obesity (8.0 v. 13.6%, P=0.019, and 8.4 v. 13.4%, P=0.014, respectively) was less frequent in the GDM offspring. At age 5–10 years, increased overweight (22.2 v. 12.1%, P<0.001) and obesity (15.9 v. 9.0%, P=0.001) were found in the GDM group, which was associated with maternal obesity, being born large-for-gestational age, male gender and formula feeding. After adjusting for confounding factors, GDM remained an independent determinant of offspring overweight and obesity (aOR 2.28, 95% CI 1.61–3.22), suggesting that the effects of GDM were independent of breast feeding, as well as of maternal obesity and birth size.

Type
Original Article
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Shaw, JE, Sicree, RA, Zimmet, PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010; 87, 414.Google Scholar
2. Yu, Z, Han, S, Chu, J, et al. Trends in overweight and obesity among children and adolescents in China from 1981 to 2010: a meta-analysis. PLoS One. 2012; 7, e51949.CrossRefGoogle Scholar
3. Spencer, SJ. Early life programming of obesity: the impact of the perinatal environment on the development of obesity and metabolic dysfunction in the offspring. Curr Diabetes Rev. 2012; 8, 5568.Google Scholar
4. Malcolm, J. Through the looking glass: gestational diabetes as a predictor of maternal and offspring long-term health. Diabetes Metab Res Rev. 2012; 28, 307311.CrossRefGoogle ScholarPubMed
5. Kim, SY, England, JL, Sharma, JA, Njoroge, T. Gestational diabetes mellitus and risk of childhood overweight and obesity in offspring: a systematic review. Exp Diabetes Res. 2011; 22, 19.CrossRefGoogle Scholar
6. Zhao, YL, Ma, RM, Huang, YK, Liang, K, Ding, ZB. Effect of breastfeeding on childhood overweight in the offspring of mothers with gestational diabetes mellitus. Zhongguo Dang Dai Er Ke Za Zhi. 2013; 15, 5661.Google ScholarPubMed
7. Ma, RM, Lao, TT, Sun, YH, et al. Practice audits to reduce caesareans in a tertiary referral hospital in south-western China. Bull World Health Organ. 2012; 90, 488494.Google Scholar
8. Ma, RM, Lao, TT, Ma, CL, et al. Relationship between leg length and gestational diabetes mellitus in Chinese pregnant women. Diabetes Care. 2007; 30, 29602961.Google Scholar
9. Du, MY, Ma, RM, Lao, TT, et al. Early third trimester maternal response to glucose challenge and pregnancy outcome in Chinese women-relationship between upper distribution level and recommended diagnostic criteria. Eur J Clin Nutr. 2015; 28, E-pub ahead of print; doi: 10.1038/ejcn.2014.293.Google Scholar
10. Kousta, E, Lawrence, NJ, Penny, A, et al. Implications of new diagnostic criteria for abnormal glucose homeostasis in women with previous gestational diabetes. Diabetes Care. 1999; 22, 933937.Google Scholar
11. Zhang, Y, Ma, RM, Wang, J, et al. Birth weight percentile in normal singleton pregnancy in Kunming region. Prog Obstet Gynecol. 2010; 9, 99103.Google Scholar
12. Li, H, Ji, CY, Zong, XN, Zhang, YQ. Body mass index curves for Chinese and adolescents aged 0-18years. Zhonghua Er Ke Za Zhi. 2009; 47, 493498.Google Scholar
13. Gillman, MW, Rifas-Shiman, S, Berkey, CS, Field, AE, Colditz, GA. Maternal gestational diabetes, birth weight, and adolescent obesity. Pediatrics. 2003; 111, e221e226.CrossRefGoogle ScholarPubMed
14. Lawlor, DA, Fraser, A, Lindsay, RS, et al. Association of existing diabetes, gestational diabetes and glycosuria in pregnancy with macrosomia and offspring body mass index, waist and fat mass in later childhood: findings from a prospective pregnancy cohort. Diabetologia. 2010; 53, 8997.CrossRefGoogle ScholarPubMed
15. Hillier, TA, Pedula, KL, Schmidt, MM, et al. Childhood obesity and metabolic imprinting: the ongoing effects of maternal hyperglycemia. Diabetes Care. 2007; 30, 22872292.Google Scholar
16. Tam, WH, Ma, RC, Yang, X, et al. Glucose intolerance and cardiometabolic risk in children exposed to maternal gestational diabetes mellitus in utero. Pediatrics. 2008; 122, 12291234.CrossRefGoogle ScholarPubMed
17. Tam, WH, Ma, RC, Yang, X, et al. Glucose intolerance and cardiometabolic risk in adolescents exposed to maternal gestational diabetes: a 15-year follow-up study. Diabetes Care. 2010; 33, 13821384.CrossRefGoogle ScholarPubMed
18. Taylor, RW, Grant, AM, Goulding, A, Williams, SM. Early adiposity rebound: review of papers linking this to subsequent obesity in children and adults. Curr Opin Clin Nutr Metab Care. 2005; 8, 607612.Google Scholar
19. Owen, CG, Martin, RM, Whincup, PH, Smith, GD, Cook, DG. Effect of infant feeding on the risk of obesity across the life course: a quantitative review of published evidence. Pediatrics. 2005; 115, 13671377.Google Scholar
20. Plagemann, A, Harder, T, Frank, k, Kolhoff, R. Long-term impact of neonatal breasting-feeding on body weight and glucose tolerance in children of diabetic mothers. Diabetes Care. 2002; 25, 1622.CrossRefGoogle ScholarPubMed
21. Crume, TL, Ogden, L, Maligie, M, et al. Long-term impact of neonatal breastfeeding on childhood adiposity and fat distribution among children exposed to diabetes in utero. Diabetes Care. 2011; 34, 641645.Google Scholar