CoChat
Sign Up
Cited by 0Gestational Diabetes Research and ManagementBirth, Development, and HealthDiabetes, Cardiovascular Risks, and Lipoproteins

Maternal Gestational Diabetes and Trajectories of Offspring Fat–Lean Balance in the Millennium Cohort Study

Open access
Du, Jiaxing, Wu, Shiyan, Wang, Yanyan, Liu, Mei, Huang, Jiayu, Zhao, Yanhan, Lin, Yan·2026·Diabetes, Obesity and Metabolism
DOI 10.1111/dom.71260
Open this paper in CoChat — free accountOpen PDF

Abstract

Aims: We aimed to examine whether offspring exposed to maternal gestational diabetes mellitus (GDM) had different fat–lean balance trajectories from unexposed offspring and whether the estimated associations were attenuated after adjustment for maternal pre‐pregnancy adiposity. Methods: Using UK Millennium Cohort Study data, we analysed body composition outcomes, including fat mass (FM), body fat percentage (BF%), fat mass index (FMI), fat‐free mass index (FFMI), and the FMI/FFMI ratio. Linear mixed‐effects models characterised body composition trajectories from ages 7–17 years, with additional adjustment to assess the attenuation of the estimates after accounting for maternal pre‐pregnancy adiposity. Results: The analysis included 14 329 offspring, of whom 170 were exposed to maternal GDM. In the primary adjusted model, GDM‐exposed offspring had higher model‐predicted values for all body composition indices than unexposed offspring across the observed ages. GDM‐by‐age interaction terms indicated age‐varying between‐group differences for FM, FMI, and the FMI/FFMI ratio (all p < 0.05), with borderline evidence for BF% ( p = 0.050) and no clear evidence for FFMI. After additional adjustment for maternal pre‐pregnancy adiposity, the estimated between‐group differences were attenuated, and some age‐specific contrasts, particularly at age 7 years, were no longer statistically significant. Nevertheless, age‐varying between‐group patterns remained evident for several body composition indices. Conclusion: Maternal GDM exposure was associated with age‐varying differences in offspring fat mass and fat–lean balance during childhood and adolescence, and these associations were attenuated after adjustment for maternal pre‐pregnancy adiposity.

AI snapshot

Written from the paper’s full text.

TL;DR

In the UK Millennium Cohort Study, offspring exposed to maternal gestational diabetes mellitus (GDM) had higher model-predicted fat mass and fat–lean balance indices from ages 7–17 years than unexposed offspring, with age-varying differences for several measures. These estimated differences were attenuated after adjustment for maternal pre-pregnancy adiposity, though some age-related patterns remained.

Key findings

  • Among 14,329 offspring, 170 (1.2%) were exposed to maternal GDM. In the primary adjusted model (Model 2), GDM-exposed offspring had higher predicted values for fat mass (FM), body fat percentage (BF%), fat mass index (FMI), fat-free mass index (FFMI), and the FMI/FFMI ratio across observed ages.
  • Significant GDM-by-age interactions were found for FM (linear β = 0.568, 95% CI 0.215–0.921, p = 0.002; quadratic β = −0.043, 95% CI −0.079 to −0.008, p = 0.016), FMI (linear β = 0.170, 95% CI 0.045–0.295, p = 0.008; quadratic β = −0.014, 95% CI −0.026 to −0.001, p = 0.032), and the FMI/FFMI ratio (linear β = 0.0088, 95% CI 0.0018–0.0159, p = 0.014; quadratic β = −0.0009, 95% CI −0.0016 to −0.0002, p = 0.016). BF% showed borderline evidence (quadratic p = 0.050), and FFMI showed no clear evidence of age-varying differences (both p > 0.05).
  • After additional adjustment for maternal pre-pregnancy adiposity (Model 3), between-group differences were attenuated, and some age-specific contrasts, particularly at age 7 years, were no longer statistically significant. Age-varying patterns remained evident for FM, BF%, FMI, and the FMI/FFMI ratio, but not clearly for FFMI.
  • At 80% power, minimum detectable effects across ages 7–17 years ranged from 1.349–1.658 kg for FM, 1.507–1.835 percentage points for BF%, 0.522–0.624 kg/m² for FMI, 0.316–0.392 kg/m² for FFMI, and 0.028–0.034 for the FMI/FFMI ratio.

Methods

  • Prospective UK Millennium Cohort Study analysis of 14,329 offspring with documented maternal GDM status, baseline information, and valid height, weight, and bioelectrical impedance analysis (BIA)-derived body fat percentage at one or more sweeps at ages 7, 11, 14, or 17 years. Twin or higher-order multiple pregnancies were excluded. Maternal GDM was self-reported at Sweep 1 (about 9 months postpartum); mothers reporting other diabetes types without GDM were excluded.
  • Outcomes were BIA-derived FM, BF%, FMI, FFMI, and FMI/FFMI ratio. Linear mixed-effects models included a child-specific random intercept, age centered at 7 years with linear and quadratic terms, and GDM × age and GDM × age² interactions. Model 1 was unadjusted; Model 2 adjusted for child sex, country of residence, gestational age, ethnicity, parental education, household income, breastfeeding duration, delivery mode, and Index of Multiple Deprivation; Model 3 further adjusted for maternal pre-pregnancy adiposity.
  • Missing covariate data were handled with multiple imputation by chained equations (20 imputed datasets, 20 iterations), with Rubin’s rules for combining estimates. Five sensitivity analyses assessed propensity-score overlap weighting, a stricter GDM definition, natural cubic spline age modelling, alternative imputation settings, and complete-case analysis.

Limitations

  • The paper states that maternal GDM was identified from a single retrospective self-report at the 9-month postpartum interview, with relatively low observed prevalence suggesting possible under-ascertainment; absence of clinical glycaemic and pregnancy-specific treatment information may have introduced exposure misclassification and prevented analyses by GDM severity.
  • The paper states that the observational design precludes causal inference, and residual confounding from gestational weight gain, prenatal diet, physical activity, shared genetic susceptibility, and postnatal lifestyle cannot be excluded. Body composition was estimated using foot-to-foot BIA, which may be affected by hydration, pubertal development, body size, and device-specific algorithms, and direct measures of visceral or regional fat were unavailable. Measurements were available only at ages 7, 11, 14, and 17 years, precluding identification of when differences first emerged and limiting characterization of changes between assessments. The small and markedly imbalanced GDM-exposed group limited precision and precluded reliable sex-stratified analyses.
  • The text also makes evident that attenuation after adjustment for maternal pre-pregnancy adiposity should not be interpreted as evidence of mediation, as the authors explicitly note.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1111/dom.71260

Cites

29 of 29 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 29 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Additional adjustment for maternal pre-pregnancy adiposity attenuated the estimated GDM-non-GDM differences across outcomes.

    “This additional adjustment attenuated the estimated GDM-non-GDM differences across outcomes (Figure 2; Table S5).”
    • Also stated in: § Abstract · hedged
      “After additional adjustment for maternal pre-pregnancy adiposity, the estimated between-group differences were attenuated”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Maternal self-reported GDM status accurately classifies gestational diabetes mellitus exposure.
    • Rests on an assumption: Bioelectrical impedance analysis (BIA)-derived body composition estimates accurately measure the corresponding body composition compartments.
    • Rests on an assumption: Maternal pre-pregnancy adiposity is a confounder of the GDM-offspring body composition association, not a mediator.
  • Findingown data

    In the primary adjusted model (Model 2), GDM-exposed offspring had higher model-predicted values for all body composition indices (FM, BF%, FMI, FFMI, and the FMI/FFMI ratio) than unexposed offspring across the observed ages from 7 to 17 years.

    “In the primary adjusted model, GDM-exposed offspring had higher model-predicted values for all body composition indices than unexposed offspring across the observed ages.”
    • Also stated in: § 3 | Results · plain
      “In the primary adjusted model (Model 2), GDM-exposed offspring had higher modelpredicted values for FM, BF%, FMI, FFMI, and the FMI/FFMI ratio than unexposed offspring across the observed ages.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Maternal self-reported GDM status accurately classifies gestational diabetes mellitus exposure.
    • Rests on an assumption: Bioelectrical impedance analysis (BIA)-derived body composition estimates accurately measure the corresponding body composition compartments.
  • Findingown data

    For BF%, the quadratic GDM × age2 interaction provided borderline evidence of an age-varying difference (p = 0.050).

    “For BF%, the quadratic interaction provided borderline evidence of an age-varying difference (p = 0.050).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Maternal self-reported GDM status accurately classifies gestational diabetes mellitus exposure.
    • Rests on an assumption: Bioelectrical impedance analysis (BIA)-derived body composition estimates accurately measure the corresponding body composition compartments.
    • Rests on an assumption: The linear and quadratic age terms adequately capture the trajectories of body composition from ages 7 to 17 years.
  • Findingown data

    Higher maternal pre-pregnancy adiposity was associated with higher offspring values for all body composition indices (all p < 0.001).

    “Higher maternal pre-pregnancy adiposity was associated with higher offspring values for all body composition indices (all p < 0.001).”
    Quote in the paperNot a substantial claim
  • Findingown data

    Maternal GDM exposure was associated with age-varying differences in offspring fat mass and fat-lean balance from childhood through adolescence.

    “Maternal GDM exposure was associated with age-varying differences in offspring fat mass and fat-lean balance from childhood through adolescence.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 26
  • May combine two claims. 29

  • Classified as probably not a substantial claim. May combine two claims.

    Findingown data

    The analytical sample included 14,329 offspring, of whom 170 (1.2%) were exposed to maternal GDM.

    “The analytical sample included 14 329 offspring, of whom 7271 (50.7%) were male and 170 (1.2%) were exposed to maternal GDM.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The magnitude of between-group differences in body composition varied with age for most outcomes, generally increasing during childhood or early adolescence and narrowing later in adolescence; FFMI showed less evidence of an age-varying pattern.

    “The magnitude of these between-group differences varied with age for most outcomes, generally increasing during childhood or early adolescence and narrowing later in adolescence; FFMI showed less evidence of an age-varying pattern.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Maternal self-reported GDM status accurately classifies gestational diabetes mellitus exposure.
    • Rests on an assumption: Bioelectrical impedance analysis (BIA)-derived body composition estimates accurately measure the corresponding body composition compartments.
    • Rests on an assumption: The linear and quadratic age terms adequately capture the trajectories of body composition from ages 7 to 17 years.

  • May combine two claims.

    Findingown data

    After additional adjustment for maternal pre-pregnancy adiposity, age-varying differences remained evident for FM, BF%, FMI, and the FMI/FFMI ratio, whereas FFMI continued to show no clear interaction.

    “Nevertheless, age-varying differences remained evident for FM, BF%, FMI, and the FMI/FFMI ratio, whereas FFMI continued to show no clear interaction.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Maternal self-reported GDM status accurately classifies gestational diabetes mellitus exposure.
    • Rests on an assumption: Bioelectrical impedance analysis (BIA)-derived body composition estimates accurately measure the corresponding body composition compartments.
    • Rests on an assumption: The linear and quadratic age terms adequately capture the trajectories of body composition from ages 7 to 17 years.
    • Rests on an assumption: Maternal pre-pregnancy adiposity is a confounder of the GDM-offspring body composition association, not a mediator.

  • May combine two claims.

    Findingown data

    For the FMI/FFMI ratio, both the linear GDM × age interaction (β = 0.0088, 95% CI 0.0018 to 0.0159; p = 0.014) and the quadratic GDM × age2 interaction (β = -0.0009, 95% CI -0.0016 to -0.0002; p = 0.016) were statistically significant.

    “and the FMI/FFMI ratio (linear interaction: β = 0.0088, 95% CI 0.0018 to 0.0159; p = 0.014; quadratic interaction: β = -0.0009,95% CI -0.0016 to -0.0002; p = 0.016).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Maternal self-reported GDM status accurately classifies gestational diabetes mellitus exposure.
    • Rests on an assumption: Bioelectrical impedance analysis (BIA)-derived body composition estimates accurately measure the corresponding body composition compartments.
    • Rests on an assumption: The linear and quadratic age terms adequately capture the trajectories of body composition from ages 7 to 17 years.

  • May combine two claims.

    Findingown data

    For FFMI, neither the GDM × age nor the GDM × age2 interaction term was statistically significant (both p > 0.05).

    “Neither interaction term was significant for FFMI (both p > 0.05); given the small number of GDM-exposed offspring, this result should be interpreted as imprecise rather than as definitive evidence of no difference.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Maternal self-reported GDM status accurately classifies gestational diabetes mellitus exposure.
    • Rests on an assumption: Bioelectrical impedance analysis (BIA)-derived body composition estimates accurately measure the corresponding body composition compartments.
    • Rests on an assumption: The linear and quadratic age terms adequately capture the trajectories of body composition from ages 7 to 17 years.

  • May combine two claims.

    Findingown data

    In the primary adjusted model, the predicted FMI/FFMI ratio was higher in GDM-exposed offspring at each observed age, and the significant GDM-by-age interaction terms indicated that the magnitude of this difference varied with age.

    “In the primary adjusted model, the predicted FMI/ FFMI ratio was higher in GDM-exposed offspring at each observed age, while the significant GDM-by-age interaction terms indicated that the magnitude of this difference varied with age.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Maternal self-reported GDM status accurately classifies gestational diabetes mellitus exposure.
    • Rests on an assumption: Bioelectrical impedance analysis (BIA)-derived body composition estimates accurately measure the corresponding body composition compartments.
    • Rests on an assumption: The linear and quadratic age terms adequately capture the trajectories of body composition from ages 7 to 17 years.

  • May combine two claims.

    Findingown data

    For FM, both the linear GDM × age interaction (β = 0.568, 95% CI 0.215 to 0.921; p = 0.002) and the quadratic GDM × age2 interaction (β = -0.043, 95% CI -0.079 to -0.008; p = 0.016) were statistically significant.

    “For FM, both the linear interaction (β = 0.568, 95% CI 0.215 to 0.921; p = 0.002) and quadratic interaction (β = -0.043,95% CI -0.079 to -0.008; p = 0.016) were significant.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Maternal self-reported GDM status accurately classifies gestational diabetes mellitus exposure.
    • Rests on an assumption: Bioelectrical impedance analysis (BIA)-derived body composition estimates accurately measure the corresponding body composition compartments.
    • Rests on an assumption: The linear and quadratic age terms adequately capture the trajectories of body composition from ages 7 to 17 years.

  • May combine two claims.

    Findingown data

    For FMI, both the linear GDM × age interaction (β = 0.170, 95% CI 0.045 to 0.295; p = 0.008) and the quadratic GDM × age2 interaction (β = -0.014, 95% CI -0.026 to -0.001; p = 0.032) were statistically significant.

    “Similar nonlinear patterns were observed for FMI (linear interaction: β = 0.170, 95% CI 0.045 to 0.295; p = 0.008; quadratic interaction: β = -0.014,95% CI -0.026 to -0.001; p = 0.032)”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Maternal self-reported GDM status accurately classifies gestational diabetes mellitus exposure.
    • Rests on an assumption: Bioelectrical impedance analysis (BIA)-derived body composition estimates accurately measure the corresponding body composition compartments.
    • Rests on an assumption: The linear and quadratic age terms adequately capture the trajectories of body composition from ages 7 to 17 years.

  • May combine two claims.

    Findingown data

    In the present study, FMI showed age-varying between-group differences, whereas FFMI did not.

    “In the present study, FMI showed age-varying between-group differences, whereas FFMI did not.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    In the HAPO Follow-up Study, retrospectively defined GDM and higher maternal glucose levels were associated with greater childhood obesity and adiposity at ages 10-14 years.

    “In the Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study, retrospectively defined GDM and higher maternal glucose levels were associated with greater childhood obesity and adiposity at ages 10-14 years [13,15].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [13]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [15]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationown data

    Maternal GDM exposure was associated with age-varying differences in offspring fat mass and fat-lean balance during childhood and adolescence, and these associations were attenuated after adjustment for maternal pre-pregnancy adiposity.

    “Maternal GDM exposure was associated with age-varying differences in offspring fat mass and fat-lean balance during childhood and adolescence, and these associations were attenuated after adjustment for maternal pre-pregnancy adiposity.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Maternal self-reported GDM status accurately classifies gestational diabetes mellitus exposure.
    • Rests on an assumption: Bioelectrical impedance analysis (BIA)-derived body composition estimates accurately measure the corresponding body composition compartments.
    • Rests on an assumption: The linear and quadratic age terms adequately capture the trajectories of body composition from ages 7 to 17 years.
    • Rests on an assumption: Maternal pre-pregnancy adiposity is a confounder of the GDM-offspring body composition association, not a mediator.

  • May combine two claims.

    Premisecitation

    Maternal pre-pregnancy adiposity is associated with both GDM and offspring body composition and may therefore be an important confounder of the observed association.

    “Maternal pre-pregnancy adiposity is associated with both GDM and offspring body composition and may therefore be an important confounder of the observed association [7].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [7]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Missingness was generally low to moderate, and the distributions of baseline variables were similar before and after multiple imputation.

    “Missingness was generally low to moderate, and the distributions of baseline variables were similar before and after multiple imputation (Tables S1 and S2).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Maternal GDM exposes the developing fetus to an altered intrauterine metabolic environment and is associated with an increased long-term risk of type 2 diabetes and related cardiometabolic dysfunction in offspring.

    “Maternal gestational diabetes mellitus (GDM) exposes the developing fetus to an altered intrauterine metabolic environment and is associated with an increased long-term risk of type 2 diabetes and related cardiometabolic dysfunction in offspring [1,2].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [1]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [2]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Other longitudinal evidence suggests that the association between GDM and offspring overweight or elevated body fat may become more apparent from early to middle childhood.

    “Other longitudinal evidence suggests that the association between GDM and offspring overweight or elevated body fat may become more apparent from early to middle childhood [16].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Premisecitation

    FMI/FFMI is mathematically equivalent to the FM/FFM ratio.

    “Because FMI/FFMI is mathematically equivalent to the FM/FFM ratio, it is consistent with the broader load-capacity framework, in which fat mass represents metabolic load and fat-free mass contributes to metabolic capacity [17].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [17]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The Millennium Cohort Study (MCS) is a multidisciplinary, nationally representative prospective birth cohort in the United Kingdom.

    “The present study utilized data from the Millennium Cohort Study (MCS), a multidisciplinary, nationally representative prospective birth cohort in the United Kingdom [14].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [14]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Deng et al. reported a positive GDM-by-age interaction for offspring skinfold thickness measured at birth and at ages 7 and 10 years.

    “Deng et al. similarly reported a positive GDM-by-age interaction for offspring skinfold thickness measured at birth and at ages 7 and 10 years [12].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Post hoc minimum detectable effect (MDE) analyses were performed for each outcome at ages 7, 11, 14 and 17 years to characterize the effect sizes detectable with the available sample and the marked imbalance between exposure groups.

    “To characterize the effect sizes detectable with the available sample and the marked imbalance between exposure groups, post hoc minimum detectable effect (MDE) analyses were performed for each outcome at ages 7, 11, 14 and 17 years.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Five sensitivity analyses assessed the robustness of the findings.

    “Five sensitivity analyses assessed the robustness of the findings:”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Missing covariate data were addressed using multiple imputation by chained equations under a missing-at-random assumption.

    “Missing covariate data were addressed using multiple imputation by chained equations under a missing-at-random assumption.”
    Quote in the paperSubstantial claim
    • The authors state this as an assumption: Missing covariate data are missing at random.

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Model 3 additionally adjusted for maternal pre-pregnancy adiposity.

    “Model 3 additionally adjusted for maternal pre-pregnancy adiposity (Table S4).”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Linear mixed-effects models were used to estimate body composition trajectories from ages 7 to 17 years while accommodating unbalanced repeated measurements and within-child correlation.

    “Linear mixed-effects models (LMMs) were used to estimate body composition trajectories from ages 7 to 17 years while accommodating unbalanced repeated measurements and withinchild correlation.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    The between-group difference in fat-lean balance was consistently observed across the assessed ages but was not constant in magnitude.

    “These findings indicate that the between-group difference in fat-lean balance was consistently observed across the assessed ages but was not constant in magnitude.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Our findings are consistent with epidemiological evidence linking maternal GDM to greater offspring adiposity, although the strength of the association varies across adiposity measures.

    “Our findings are consistent with epidemiological evidence linking maternal GDM to greater offspring adiposity, although the strength of the association varies across adiposity measures.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Maternal hyperglycaemia may promote fetal hyperinsulinaemia and adipogenesis, and imaging studies suggest that this environment may favour fat accretion over lean tissue growth.

    “Maternal hyperglycaemia may promote fetal hyperinsulinaemia and adipogenesis [18], and imaging studies suggest that this environment may favour fat accretion over lean tissue growth [19,20].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [18]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [19]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [20]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    Most epidemiological studies have relied on body mass index (BMI), which cannot distinguish fat mass from fat-free mass.

    “Most epidemiological studies, however, have relied on body mass index (BMI), which cannot distinguish fat mass from fat-free mass [6].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [6]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Study design and conductown data

    In the complete-case sensitivity analysis, the BF% GDM × age2 term was no longer statistically significant (p = 0.081), compared with borderline evidence in the primary analysis (p = 0.050).

    “The main exception was BF% in the complete-case analysis, in which the GDM × age 2 term was no longer statistically significant (p = 0.081), compared with borderline evidence in the primary analysis (p = 0.050).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Maternal self-reported GDM status accurately classifies gestational diabetes mellitus exposure.
    • Rests on an assumption: Bioelectrical impedance analysis (BIA)-derived body composition estimates accurately measure the corresponding body composition compartments.
    • Rests on an assumption: The linear and quadratic age terms adequately capture the trajectories of body composition from ages 7 to 17 years.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The largest between-group imbalances were observed for maternal pre-pregnancy BMI category, mode of delivery, gestational age, country of residence, ethnicity and parental education.

    “The largest between-group imbalances were observed for maternal pre-pregnancy BMI category, mode of delivery, gestational age, country of residence, ethnicity and parental education.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    The repeated assessments at ages 7, 11, 14 and 17 years enable the estimation of broad age-related patterns in body composition, although changes between measurement occasions cannot be observed directly.

    “The repeated assessments available in the present study at ages 7, 11, 14 and 17 years enable the estimation of broad age-related patterns in body composition, although changes between measurement occasions cannot be observed directly.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisereasoning

    Bioelectrical impedance analysis (BIA) allows estimation of body fat percentage, fat mass, and fat-free mass, providing a more detailed characterization of fat-lean balance than conventional anthropometric measures alone.

    “Bioelectrical impedance analysis (BIA) further allows estimation of body fat percentage, fat mass, and fat-free mass, providing a more detailed characterization of fat-lean balance than conventional anthropometric measures alone.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    The attenuation observed in Model 3 indicates that the estimated associations were sensitive to adjustment for maternal pre-pregnancy adiposity; however, it should not be interpreted as evidence of mediation.

    “The attenuation observed in Model 3 indicates that the estimated associations were sensitive to adjustment for maternal pre-pregnancy adiposity; however, it should not be interpreted as evidence of mediation.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Maternal pre-pregnancy adiposity is a confounder of the GDM-offspring body composition association, not a mediator.

  • May combine two claims.

    Premisecitation

    Higher maternal adiposity is associated with altered adipokine profiles and increased inflammatory activity during pregnancy.

    “Higher maternal adiposity is also associated with altered adipokine profiles and increased inflammatory activity during pregnancy [8,9].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [8]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [9]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Adjusted GVIFs ranged from 1.001 to 1.197 across imputed datasets, indicating no problematic multicollinearity in Model 3.

    “Adjusted GVIFs ranged from 1.001 to 1.197 across imputed datasets, indicating no problematic multicollinearity in Model 3.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    At 80% power, the minimum detectable effects across ages 7-17 years ranged from 1.349 to 1.658 kg for FM, 1.507 to 1.835 percentage points for BF%, 0.522 to 0.624 kg/m2 for FMI, 0.316 to 0.392 kg/m2 for FFMI, and 0.028 to 0.034 for the FMI/FFMI ratio.

    “At 80% power, the MDEs across ages 7-17 years ranged from 1.349 to 1.658 kg for FM, 1.507 to 1.835 percentage points for BF%, 0.522 to 0.624 kg/m 2 for FMI, 0.316 to 0.392 kg/m 2 for FFMI, and 0.028 to 0.034 for the FMI/FFMI ratio.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In Project Viva, gestational glucose tolerance was associated with adiposity-related measures, including FMI, in a sex-specific manner, whereas associations with lean or fat-free mass were weak or absent.

    “In Project Viva, gestational glucose tolerance was associated with adiposityrelated measures, including FMI, in a sex-specific manner, whereas associations with lean or fat-free mass were weak or absent [28].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [28]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Maternal GDM was identified using a single retrospective self-reported item at the 9-month postpartum interview.

    “First, maternal GDM was identified using a single retrospective self-reported item at the 9-month postpartum interview”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Maternal pre-pregnancy adiposity may contribute to this environment before overt hyperglycaemia develops, and observational studies have linked higher maternal BMI to greater offspring fat mass and, in some settings, lower lean mass.

    “Maternal pre-pregnancy adiposity may contribute to this environment before overt hyperglycaemia develops [23], and observational studies have linked higher maternal BMI to greater offspring fat mass and, in some settings, lower lean mass [24,25].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [23]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [24]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [25]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationreasoning

    GDM-related differences may be more apparent in fat accumulation and in the proportional balance between fat and fat-free mass than in fat-free mass alone.

    “Taken together, these findings suggest that GDM-related differences may be more apparent in fat accumulation and in the proportional balance between fat and fat-free mass than in fat-free mass alone.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Gingras et al. reported no statistically significant association between GDM exposure and offspring FMI in early adolescence.

    “Gingras et al. likewise reported no statistically significant association between GDM exposure and offspring FMI in early adolescence [29].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [29]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Body composition was estimated using foot-to-foot BIA.

    “body composition was estimated using foot-to-foot BIA”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Direct measures of visceral or regional fat were unavailable.

    “direct measures of visceral or regional fat were unavailable”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Foot-to-foot BIA may be affected by hydration, pubertal development, body size, and device-specific algorithms.

    “which may be affected by hydration, pubertal development, body size, and device-specific algorithms”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationown data

    Considering maternal metabolic health is important when interpreting offspring body composition development.

    “underscoring the importance of considering maternal metabolic health when interpreting offspring body composition development”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    Given the observational design, causal inference is not possible.

    “given the observational design, causal inference is not possible”
    Quote in the paperSubstantial claim
45 of 45

  • The authors state this as an assumption.

    Missing covariate data are missing at random.

    “under a missing-at-random assumption”

  • The paper relies on this without support.

    Maternal self-reported GDM status accurately classifies gestational diabetes mellitus exposure.

    “Maternal GDM status was ascertained by maternal self-report at Sweep 1.”

  • The paper relies on this without support.

    Bioelectrical impedance analysis (BIA)-derived body composition estimates accurately measure the corresponding body composition compartments.

    “Body weight and BF% were measured using a battery-powered Tanita BF-522 W foot-to-foot BIA scale (Tanita Corporation, Tokyo, Japan) in accordance with standardized MCS protocols.”

  • The paper relies on this without support.

    The linear and quadratic age terms adequately capture the trajectories of body composition from ages 7 to 17 years.

    “Age was centered at 7 years and modelled using linear and quadratic terms.”

  • The paper relies on this without support.

    Maternal pre-pregnancy adiposity is a confounder of the GDM-offspring body composition association, not a mediator.

    “however, it should not be interpreted as evidence of mediation.”
5 of 5

Cites

Flagged first, then by citations

Authors
Du, J., Wu, S., Wang, Y., Liu, M., Huang, J., Zhao, Y., & Lin, Y.
Affiliations
  • Guangzhou Women and Children Medical Center (CN)
  • Guangzhou Medical University (CN)
Corresponding author
Lin, Yan
ORCID
Venue
Diabetes, Obesity and Metabolism
Publisher
Wiley
Published
2026-08-25
Volume
28
Issue
11
Pages
10475-10485
ISSN
  • 1462-8902 (ISSN-L)
  • 1463-1326
DOI
10.1111/dom.71260
OpenAlex
W7204209249
Cited by
0
References
10
FWCI
0.00
Type
journal article
Language
en
Open access
Licence
Locations
  • Diabetes Obesity and Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
offspring body composition, fat mass, fat mass index, fat-free mass index, body fat percentage, childhood and adolescence, developmental trajectories, Millennium Cohort Study
MeSH terms
Developmental Origins of Health and Disease, Adipose Tissue, Adolescent, Adult, Body Composition, Child, Female, United Kingdom, Humans, Male, Pregnancy, Prenatal Exposure Delayed Effects, Cohort Studies, Body Mass Index, Diabetes, Gestational, Adiposity

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-23.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-23.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review