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A secondary analysis of a mild gestational diabetes mellitus treatment trial long-term follow-up study looked at the relationship between maternal oral glucose tolerance testing and childhood body mass index, fasting glucose, insulin and anthropometrics in the offspring of untreated mild GDM and non GDM mothers assessed at ages five to 10 years.
Researchers analyzed 236 offspring of mothers with untreated mild gestational diabetes mellitus and 481 children of mothers who were non-GDM. The relationship between maternal OGTT (24-31 weeks GA) and childhood BMI, fasting glucose, insulin and anthropometrics (sum of skinfolds (SS), subscapular/triceps ratio (STR), and waist circumference (WC)) in the offspring of untreated mild GDM and non GDM (abnormal 50 g screen/normal OGTT) was assessed at ages 5-10 years. Multivariable regression modeling controlling for maternal and neonatal characteristics was employed.
No differences for childhood fasting glucose, BMI >85th or 95th percentile, skinfolds, waist circumference or HOMA-IR (insulin resistance) was found between mild GDM and non GDM offspring.
The researchers concluded maternal glycemia is associated with some childhood anthropometric measures of obesity but not with subsequent body mass index, fasting glucose or insulin resistance. However, maternal obesity and Hispanic ethnicity were found to be most associated with childhood obesity and metabolic dysfunction.
Mark B. Landon, M.D. with the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network in Bethesda, Md, added that, "We have known for some time that maternal glycemia has a direct impact on neonatal obesity. This analysis confirms that maternal obesity is far more significant as a risk for childhood obesity than are mild elevations of glucose levels during pregnancy." "This research further suggests that efforts to reduce obesity prior to pregnancy should be emphasized in clinical practice.