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. 2018 Sep;26(9):1457-1466.
doi: 10.1002/oby.22264.

Associations of Maternal Diabetes During Pregnancy with Overweight in Offspring: Results from the Prospective TEDDY Study

Anitha Pitchika  1   2   3 , Kendra Vehik  4 , Sandra Hummel  1   2   3 , Jill M Norris  5 , Ulla M Uusitalo  4 , Jimin Yang  4 , Suvi M Virtanen  6   7   8   9 , Sibylle Koletzko  10 , Carin Andrén Aronsson  11 , Anette-G Ziegler  1   2   3 , Andreas Beyerlein  1   2   3 ; TEDDY study group
Affiliations

Associations of Maternal Diabetes During Pregnancy with Overweight in Offspring: Results from the Prospective TEDDY Study

Anitha Pitchika et al. Obesity (Silver Spring). 2018 Sep.

Abstract

Objective: This study aimed to determine the relationship between different forms of, and potential pathways between, maternal diabetes and childhood obesity at different ages.

Methods: Prospective cohort data from The Environmental Determinants of Diabetes in the Young (TEDDY) study, which was composed of 5,324 children examined from 0.25 to 6 years of age, were analyzed. Cross-sectional and longitudinal analyses taking into account potential confounders and effect modifiers such as maternal prepregnancy BMI and birth weight z scores were performed.

Results: Offspring of mothers with gestational diabetes mellitus (GDM) or type 1 diabetes mellitus (T1DM) showed a higher BMI standard deviation score and increased risk for overweight and obesity at 5.5 years of age than offspring of mothers without diabetes. While these associations could be substantially explained by maternal prepregnancy BMI in offspring of mothers with GDM, significant associations disappeared after adjustment for birth weight z scores in offspring of T1DM mothers. Furthermore, overweight risk became stronger with increasing age in offspring of mothers with diabetes compared with offspring of mothers without diabetes.

Conclusions: Maternal diabetes is associated with increased risk of offspring overweight, and the association appears to get stronger as children grow older. Indeed, intrauterine exposure to maternal T1DM may predispose children to later obesity through increased birth weight, while maternal BMI is more important in children exposed to GDM.

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Conflict of interest statement

Disclosure: The authors declared no conflict of interest.

Figures

Fig. 1:
Fig. 1:. Flowchart of children analyzed
BMI: Body mass index; GDM: Gestational diabetes; T1D: Type 1 diabetes; T2D: Type 2 diabetes
Fig.2
Fig.2. Comparison of mean BMI, weight and height standard deviations scores (SDS) with 95% confidence interval (CI) between offspring of mothers with gestational diabetes (GDM), type 1 diabetes (T1D) and no diabetes at different ages in the TEDDY study
*This figure does not include trends for offspring of type 2 diabetic mothers due to low numbers (N=14) and wide confidence intervals.
Fig. 3:
Fig. 3:. Modifications of association between child’s age (per year) and anthropometric outcomes by maternal diabetes status presented as estimates (symbols) with 95% confidence intervals (lines)
O-GDM: Offspring of gestational diabetic mothers; O-T1DM: Offspring of type 1 diabetic mothers; O-T2DM: Offspring of type 2 diabetic mothers; O-nonDM: Offspring of non-diabetic mothers; BMI: Body mass index; SDS: Standard deviation scores
See this image and copyright information in PMC

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