OBJECTIVE -To investigate the growth of children from pregnancies with gestational diabetes mellitus (GDM) and its association with antenatal maternal, fetal, and recent anthropometric parameters of mother and father. RESEARCH DESIGN AND METHODS -In 324 pregnancies of Caucasian womenwith GDM, BMI before pregnancy, maternal glycemic values, and measurements of the fetal abdominal circumference were recorded. The weight and height of infants were measured at birth and at follow-up at 5.4 years (range 2.5-8.5). In addition, somatic data from routine examinations at 6, 12, and 24 months and the BMI of parents at follow-up were obtained. BMI standard deviation scores (SDSs) were calculated based on age-correspondent data.RESULTS -At all time points, BMI was significantly above average (ϩ0.82 SDS at birth; ϩ0.56 at 6, ϩ0.35 at 12, and ϩ0.32 at 24 months; and ϩ0.66 at follow-up; P Ͻ 0.001). BMI at birth was related to BMI at follow-up (r ϭ 0.27, P Ͻ 0.001). The rate of overweight at follow-up was 37% in children with birth BMI Ն90th percentile and 25% in those with normal BMI at birth (P Ͻ 0.05). Abdominal circumference of third trimester and postprandial glucose values were related to BMI at follow-up (r ϭ 0.22 and r ϭ 0.18, P Ͻ 0.01). Recent maternal, paternal, and birth BMI were independent predictors of BMI at follow-up (r ϭ 0.42, P Ͻ 0.001). Sixty-nine percent of children of parents with BMI Ն30 kg/m 2 were overweight at follow-up compared with 20% of those with parental BMI Ͻ30 kg/m 2 (P Ͻ 0.001).CONCLUSIONS -Children of mothers with GDM have a high rate of overweight that is associated both with intrauterine growth and parental obesity. Diabetes Care 28:1745-1750, 2005G estational diabetes mellitus (GDM) reflects a metabolically altered fetal environment due to an increased maternal supply of carbohydrates leading to fetal hyperinsulinism. Stimulation of the insulin-sensitive tissue results in increased fetal growth, predominantly of the abdomen, and delivery of large-forgestational-age newborns. Clinical and experimental studies have shown that the implications of fetal hyperinsulinism reach far beyond delivery. Children of mothers with diabetes in pregnancy may develop an increased disposition for obesity and glucose intolerance through a nongenetic "fuel-mediated" mechanism (1-8).Disposition for obesity could be influenced by many factors other than maternal diabetes in pregnancy. To our knowledge, there are no studies that evaluate the contribution of maternal hyperglycemia to childhood overweight in comparison to other antepartum maternal and fetal confounders and the influence of the postnatal environment. The present large longitudinal study of infants of mothers treated for GDM aimed to evaluate the association of the level of maternal hyperglycemia during pregnancy, fetal (as assessed by ultrasound) and neonatal obesity, and childhood obesity, as well as maternal and paternal obesity in pregnancies complicated by GDM.RESEARCH DESIGN AND METHODS -The study cohort was recruited from children of mothers wh...

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