GESTATIONAL DIABETES AND THE RISK OF OFFSPRING OBESITY

Background. Intrauterine exposure to the metabolic alterations of mate rnal diabetes may increase the risk of later obesity. We determined wh ether offspring of mothers with diet-treated, gestational diabetes mel litus (GDM) have an increased risk of childhood obesity and examined t he relationship between childhood obesity and metabolic markers of GDM . Methods. At a health maintenance organization in Seattle, WA, we rev iewed medical records to obtain the life-time height and weight measur ements of 524, 8- to 10-year-old children whose mothers had been scree ned for GDM. Maternal plasma glucose and triglyceride levels were obta ined in midgestation 1 hour after ingestion of 50 g of glucose. Those with glucose screening levels greater than or equal to 7.77 mmol/L (14 0 mg/dL) underwent a 3-hour, 100-g, oral glucose tolerance test to det ermine GDM status. Cord serum insulin levels also were obtained at bir th. Obesity was defined as an average body mass index between 5 and 10 years of age at or above the 85th percentile for age and sex. Results . The prevalence of obesity was 19% in the 58 offspring of mothers wit h diet-treated GDM and 24% in the 257 offspring of mothers with negati ve glucose screen values. There also was no difference in mean body ma ss index (adjusted for age and sex) between these two groups of offspr ing. Among all 524 offspring, there was no significant increase in the rate of offspring obesity according to the quartile of maternal scree ning glucose, triglyceride, oral glucose tolerance test, or cord serum insulin level. Conclusion. Prenatal exposure to the metabolic effects of mild, diet-treated GDM does not increase the risk of childhood obe sity.