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The Effect of Maternal Hyperglycemia on Childhood Adiposity

Sep 12, 2014

Daughters exposed to maternal hyperglycemia will have a higher risk of childhood adiposity…. 

Dr. Ai Kubo from the Kaiser Permanente Division of Research in Oakland, California, and colleagues conducted a longitudinal study to assess the association between pregnancy hyperglycemia, gestational diabetes (GDM) and offspring adiposity. This study involved 421 mother-daughter pairs at Kaiser Permanente Northern California. Maternal pregnancy glucose values were obtained from maternal medical records, and daughters’ adiposity was determined based on age-specific percentile for BMI, percent body fat (%BF) and waist to height ratio (WHR).

The results of the study revealed that girls whose mothers had the highest quintile of pregnancy glucose had significantly higher odds of having BMI ≥ 85th percentile (OR = 2.28; 95%CI 1.08-4.84), being in the upper quartile (Q4) of %BF (OR = 2.51; 95%CI 1.16-5.4), and Q4 of WHR (OR = 2.48; 95%CI 1.17-5.22) compared with girls whose mother were in the lowest glucose level (Q1). Also, in daughters who exposed to both pregnancy hyperglycemia and maternal pregravid BMI, the risk of adiposity was four times higher compared to those with neither risk factor.

Similarly, there was a significant interaction between the presence of GDM and pregravid BMI. Girls whose mothers had both risk factors had the highest odds of having a BMI >85th percentile (OR = 5.56; 95%CI 1.70-18.2), high (Q4) %BF (OR = 6.04; 95%CI 1.76-20.7), and high (Q4) WHR (OR = 3.60; 95%CI 1.35-9.58).

According to the authors, the exposure to hyperglycemia or GDM in utero might increase the risk of metabolic dysregulation in the offspring, leading to a greater adiposity. Thus, "screening and intervention for this high-risk group is warranted to slow the intergenerational transmission of obesity and its sequelae."

Practice Pearls:
  • Girls who were exposed to maternal GDM or hyperglycemia in utero have higher risk of childhood adiposity.
  • The risk is higher if mother is overweight or obese.
  • GDM or overweight mothers should be alerted of this risk to their offspring.

Kubo A, Ferrara A, Windham G, et al. Maternal hyperglycemia during pregnancy predicts adiposity of the offspring. Diabetes Care 2014; doi: 10.2337/dc14-1438.