Associations of maternal glycemia and prepregnancy BMI with early childhood growth: a prospective cohort study

Abstract

The prevalence of maternal and child overweight/obesity and gestational hyperglycemia has increased greatly in China in recent years. However, studies examining the relationship between maternal hyperglycemia, maternal prepregnancy body mass index (ppBMI), and offspring obesity in China are limited. Here, we conducted a prospective study of 6684 mother−child pairs in Wuhan, China in 2012–2015. Maternal glucose concentrations were measured at approximately 24–28 weeks of gestation; children's weight and length were measured at birth and at 6, 12, and 24 months of age; and BMI‐for‐age Z‐scores (BMIZ) were calculated for different time points. We found that maternal fasting plasma glucose (FPG) concentrations were positively associated with offspring ponderal index and the risk of macrosomia at birth, but not with BMIZ or the risk of overweight/obesity at 6, 12, and 24 months of age. By contrast, maternal ppBMI was positively associated with both an increased risk of macrosomia at birth and overweight/obesity at 6, 12, and 24 months of age. Here, we observed an interaction effect of the association of FPG and ppBMI on offspring macrosomia and a mediating effect of gestational diabetes mellitus on the pathway between ppBMI and macrosomia. Our findings suggest that maternal ppBMI is a more pronounced predictor than gestational FPG concentrations in both the relation to BMIZ and the risk of overweight/obesity in early childhood.

The Association between Pre-Pregnancy BMI, Gestational Weight Gain and Pregnancy Outcomes: A Retrospective Cohort Study in Ahvaz, Iran

“…In addition, our study and another studies [31,32] showed that gestational hyperglycemia had a positive association with macrosomia.…”

An unwelcome inheritance: childhood obesity after diabetes in pregnancy

“…Despite these limitations, there is consistent evidence of an association between maternal diabetes and child obesity, described in diverse populations including from China [ 13 ], Denmark [ 14 ], Sweden [ 15 ], Turkey [ 16 ], South Korea [ 17 ] and in the multi-ethnic Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) cohort [ 10 ]. There is also emerging evidence of a dose-dependent effect of maternal hyperglycaemia upon offspring obesity, with risk increasing proportionately with maternal glucose concentrations in pre-gestational and gestational diabetes [ 11 , 14 ].…”

Maternal circulating metabolic biomarkers and their prediction performance for gestational diabetes mellitus related macrosomia

“…Of these, more than 80% were due to GDM [ 2 ]. In recent years, with the improvement of China’s living standards and the implementation of the “universal two-child” policy, there are more and more overweight or elderly pregnant women, resulting in a sharp increase in the incidence of GDM in China [ 3 ]. Numerous studies have shown that women with GDM have a significantly increased risk of having a baby with macrosomia [ 4 ].…”