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. 2025 Oct;68(10):2205-2216.
doi: 10.1007/s00125-025-06476-6. Epub 2025 Jul 2.

Association between maternal glucose levels in pregnancy and offspring's metabolism and adiposity: an 18-year birth cohort study

Yuzhi Deng  1 , Hanbin Wu  2 , Noel Y H Ng  1 , Claudia H T Tam  1 , Atta Y T Tsang  1 , Michael H M Chan  3 , Kenneth Ka Hei Lo  4 , Chi Chiu Wang #  2   5 , Wing Hung Tam #  2   6 , Ronald C W Ma #  7   8   9
Affiliations

Association between maternal glucose levels in pregnancy and offspring's metabolism and adiposity: an 18-year birth cohort study

Yuzhi Deng et al. Diabetologia. 2025 Oct.

Abstract

Aims/hypothesis: The study aimed to explore the association between maternal glucose levels in pregnancy and offspring's metabolism and adiposity at approximately 18 years of age.

Methods: Pregnant women from the Hong Kong Field Centre enrolled in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study underwent a 75 g OGTT at 24-32 gestational weeks. Offspring's metabolic and adiposity traits were assessed at 18 years postpartum. Associations were evaluated using multiple linear regression and logistic regression.

Results: Among the 506 mother-child pairs followed up to 18 years, maternal fasting plasma glucose (FPG) in pregnancy was positively associated with offspring's FPG (β = 0.06 [95% CI 0.02, 0.09]), while maternal 1 h plasma glucose (PG) showed a positive association with offspring's FPG (β = 0.05), 30 min PG (β = 0.21) and 2 h PG (β = 0.14). All maternal glycaemic levels were associated with an increased risk of offspring being overweight/obese, particularly maternal 1 h PG (OR 1.50 [95% CI 1.17, 1.93]). Offspring of mothers with gestational diabetes mellitus showed a higher prevalence of abnormal glucose tolerance (11.86% vs 7.97%), impaired fasting glucose (1.89% vs 0.49%) and impaired glucose tolerance (10.34% vs 7.13%) than offspring of mothers with normal glucose tolerance, although these associations did not reach statistical significance in fully adjusted models, underscoring the benefit of considering maternal glucose as a continuous trait.

Conclusions/interpretation: Maternal glucose levels in pregnancy showed a long-term association with offspring's metabolic health into young adulthood, with continuous associations across the full maternal glucose spectrum, suggesting a graded effect of maternal hyperglycaemia on offspring's metabolic risk.

Keywords: Birth cohort; Gestational diabetes mellitus; Hyperglycaemia; Long-term association.

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Conflict of interest statement

Acknowledgements: The authors of the present study would like to thank the participants, researchers and others engaged in the Hong Kong HAPO study. Y. Deng acknowledges support from the Hong Kong PhD Fellowship Scheme. Some of the data were presented at the International Diabetes Epidemiology Group (IDEG) 2025 Symposium (oral presentation on Saturday 5 April 2025, Bangkok, Thailand) and the International Diabetes Federation World Diabetes Congress 2025 (oral poster presented on 9 April 2025, Bangkok, Thailand). Data availability: Data collected for the study will not be made available to others. Funding: Research Grants Council (RGC) General Research Fund (ref. 14102719) and partial support from the Health and Medical Research Fund (ref. 18190741). The funding sources did not play any role in the study design, the interpretation of the study or the decision to publish the results. Authors’ relationships and activities: The authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work. Ronald C. W. Ma is a member of the editorial board of Diabetologia. Contribution statement: YD conceptualised the study, performed formal analysis, used software, created visualisations and wrote the original draft. HW and NN contributed to the conceptualisation, methodology, investigation and manuscript review. CT contributed to the conceptualisation, methodology, validation and manuscript review. AT and MC contributed to the conceptualisation, investigation and manuscript review. KL contributed to the methodology, investigation and manuscript review. CW, WT and RM co-led the conceptualisation and investigation, provided resources and reviewed and edited the manuscript. WT led the funding acquisition. RM led the analysis, contributed to the original draft and reviewed and edited the manuscript. RM is the guarantor of this work, had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. All authors approved the final version.

Figures

Fig. 1
Fig. 1
Offspring glucose levels at 18 years old across five categories of maternal glucose levels. Mean levels of offspring’s (a) fasting glucose level, (b) 30 min glucose level, (c) 2 h glucose level and (d) sum of glucose z scores at OGTT across categories of maternal fasting, 1 h and 2 h glucose levels at OGTT in pregnancy
See this image and copyright information in PMC

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