Postnatal Prevention of Childhood Obesity in Offspring Prenatally Exposed to Gestational Diabetes mellitus: Where Are We Now

Dugas, Camille; Perron, Julie; Kearney, Michèle; Mercier, R; Tchernof, André; Marc, Isabelle; Weisnagel, S. John; Robitaille, Julie

doi:10.1159/000477407

Cited by 43 publications

(31 citation statements)

References 74 publications

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“…Breast-feeding has been shown to be inversely associated with the development of obesity [8][9][10] and women with diabetes are routinely advised to breast-feed [11,12]. In the Growing Up Today Study (GUTS), survey data collected on 15,253 offspring (aged 9-14 years) of women included in the Nurses' Health Study II (n = 116,000), showed breast-feeding to be inversely associated with obesity in the children of mothers with diabetes (n = 417 gestational diabetes and 56 pre-existing diabetes), but the association did not reach statistical significance (adjusted [a]OR 0.62 [95% CI 0.24, 1.60]) [13].…”

Section: Introductionmentioning

confidence: 99%

Association between maternal diabetes, being large for gestational age and breast-feeding on being overweight or obese in childhood

et al. 2018

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Aims/hypothesis This study aimed to examine the association of maternal diabetes, being large for gestational age (LGA) and breast-feeding with being overweight or obese in pre-school-aged children. Methods Data on height and weight at the time of their pre-school (age 4-6 years) immunisation visit between January 2009 and August 2017, as well as breast-feeding status in the first 5 months of life, for 81,226 children born between January 2005 and August 2013 were linked with maternal hospitalisation and outpatient records and birth registry data. Children were grouped into six categories based on maternal diabetes status during pregnancy (no diabetes, gestational diabetes or pre-existing diabetes) and birthweight (appropriate for gestational age [AGA] or LGA). WHO criteria were used to identify children who were overweight or obese. Results There were 69,506 children in the no diabetes/AGA group (control), 5926 in the no diabetes/LGA group, 4563 in the gestational diabetes/AGA group, 573 in the gestational diabetes/LGA group, 480 in the pre-existing diabetes/AGA group and 178 in the pre-existing diabetes/LGA group. The rate of being overweight/obese at pre-school age ranged from 20.5% in the control group to 42.9% in the gestational diabetes/LGA group. The adjusted attributable risk per cent for LGA alone (39.4%) was significantly higher than that for maternal gestational diabetes (16.0%) or pre-existing diabetes alone (15.1%); the risk for the combinations of gestational diabetes/LGA and pre-existing diabetes/LGA were 50.1% and 39.1%, respectively. Further stratification of the pre-existing diabetes groups found the prevalence of being overweight/obese was 21.2% in the type 1/AGA group, 31.4% in the type 1/LGA group (similar to those in the no diabetes groups), 26.7% in the type 2/AGA group and 42.5% in the type 2/LGA group. Breast-feeding was associated with a lower likelihood of being overweight/obese in childhood in all groups except gestational diabetes/LGA and pre-existing diabetes/LGA (both type 1 and type 2). Conclusion/interpretationLGA is a stronger marker for risk of being overweight/obese in early childhood, compared with maternal diabetes during pregnancy. Rates of being overweight/obese in childhood were highest in LGA children born to mothers with gestational diabetes or pre-existing type 2 diabetes. Breast-feeding was associated with a lower risk of being overweight/ obese in childhood in the majority of children; however, this association was not maintained in LGA children of mothers with diabetes.

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Section: Introductionmentioning

confidence: 99%

Association between maternal diabetes, being large for gestational age and breast-feeding on being overweight or obese in childhood

et al. 2018

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“…The health benefits of BF are of particular importance for mothers with overweight and/or gestational diabetes, since BF is associated with a decreased probability of type 2 diabetes [ 13 ] and a potential decrease of postpartum weight retention [ 14 , 15 ]. Children born from those women are also benefited by BF since increasing evidence indicates a protective effect against obesity and diabetes for children as well [ 16 – 18 ].…”

Section: Introductionmentioning

confidence: 99%

Maternal pre-pregnancy overweight/obesity and gestational diabetes interaction on delayed breastfeeding initiation

Pinheiro

Goldani

2018

PLoS ONE

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BackgroundCumulative evidence indicates an association between maternal overweight and gestational diabetes with delayed breastfeeding initiation; however, the presence of both conditions simultaneously has been little explored. This study aims to investigate the interaction between maternal overweight/obesity and gestational diabetes on breastfeeding initiation.MethodsThis study comprises data from the IVAPSA Birth Cohort, a prospective follow-up of mothers and their newborns. Two of the five groups from IVAPSA were evaluated, considering women with and without gestational diabetes. These women were further categorized according to their pre-pregnancy body mass index as normal weight or overweight/obese.Results219 women were evaluated, 53.4% of them had pre-pregnancy overweight/obesity and 32% had gestational diabetes. Most women were able to initiate breastfeeding within 12 hours from delivery (92.7%) and only eight (3.7%) women had not breastfed in the first 24 hours postpartum. Of these, seven were overweight/obese (77.8%) and five had gestational diabetes (66.7%), with four of them having overweight/obesity and gestational diabetes concomitantly. Women with both adverse conditions had an adjusted relative risk of delayed breastfeeding initiation of 1.072 (95% CI 1.006; 1.141), p = 0.032.ConclusionsThe results indicate an additive interaction between maternal pre-pregnancy overweight/obesity and gestational diabetes on delayed breastfeeding initiation.

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“…Infants born to GDM mothers compared to infants born from uncomplicated pregnancies, neonates are at increased risk for macrosomia, neonatal hypoglycemia, hyperbilirubinemia, shoulder dystocia, and have higher percentage of body fat ( 31 ). In the long term, offspring are also prone to developing obesity, type 2 diabetes, and other chronic metabolic disorders later in life ( 32 – 34 ). However, some studies have shown opposing findings where fetal birth weight was inversely correlated with type 2 diabetes risk dependent on ethnicity ( 35 ).…”

Section: Gestational Diabetes Mellitusmentioning

confidence: 99%

Placental Nutrient Transport in Gestational Diabetic Pregnancies

Castillo-Castrejón

Powell

2017

Front. Endocrinol.

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Maternal obesity during pregnancy is rising and is associated with increased risk of developing gestational diabetes mellitus (GDM), defined as glucose intolerance first diagnosed in pregnancy (1). Fetal growth is determined by the maternal nutrient supply and placental nutrient transfer capacity. GDM-complicated pregnancies are more likely to be complicated by fetal overgrowth or excess adipose deposition in utero. Infants born from GDM mothers have an increased risk of developing cardiovascular and metabolic disorders later in life. Diverse factors, such as ethnicity, age, fetal sex, clinical treatment for glycemic control, gestational weight gain, and body mass index among others, represent a challenge for studying underlying mechanisms in GDM subjects. Determining the individual roles of glucose intolerance, obesity, and other factors on placental function and fetal growth remains a challenge. This review provides an overview of changes in placental macronutrient transport observed in human pregnancies complicated by GDM. Improved knowledge and understanding of the alterations in placenta function that lead to pathological fetal growth will allow for development of new therapeutic interventions and treatments to improve pregnancy outcomes and lifelong health for the mother and her children.

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Postnatal Prevention of Childhood Obesity in Offspring Prenatally Exposed to Gestational Diabetes mellitus: Where Are We Now

Cited by 43 publications

References 74 publications

Association between maternal diabetes, being large for gestational age and breast-feeding on being overweight or obese in childhood

Association between maternal diabetes, being large for gestational age and breast-feeding on being overweight or obese in childhood

Maternal pre-pregnancy overweight/obesity and gestational diabetes interaction on delayed breastfeeding initiation

Placental Nutrient Transport in Gestational Diabetic Pregnancies

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