Effects of maternal gestational diabetes on offspring adiposity at 4-7 years of age

OBJECTIVE - The purpose of this study was to assess the long-term effects o f maternal prenatal factors, including gestational diabetes mellitus (GDM), adiposity, and weight gain during pregnancy, on adiposity of offspring fro m 4 to 7 years of age. A second purpose was to investigate the relationship s among childhood adiposity, blood pressure, and 2-h postprandial glucose l evel. RESEARCH DESIGN AND METHODS - Prospective observational study of four group s of children including large-for-gestational-age (LGA) offspring of mother s with gestational diabetes (OGDM); appropriate-for-gestational-age (AGA) O GDM; LGA control subjects; and AGA control subjects. Anthropometrics includ ing skin-fold measurements, blood pressure measurements, and a 2-h postpran dial glucose measurement were obtained at each visit. Repeated measures ana lysis of variance models were used to detect different patterns of longitud inal change among the groups. RESULTS - LGA OGDM were more likely to be heavier, have larger circumferenc es and skin-fold measurements, and have a higher BMI than AGA OGDM and cont rol subjects, and these findings increased with increasing age. Blood press ures and postprandial glucose values were similar for OGDM and control subj ects at 4-7 years. Multivariable analyses showed that infant BMI and matern al prepregnant BMI predicted 7-year BMI for OGDM, whereas for control subje cts, maternal prepregnancy BMI and weight gain during pregnancy were positi ve predictors with a small negative contribution from birth BMI. CONCLUSIONS - We conclude that LGA OGDM have evidence of increasing body si ze and adiposity with increasing age and that maternal GDM and maternal pre pregnant adiposity are significant predictors of their unique growth patter ns.