Maternal gestational diabetes mellitus and offspring body mass index from 1 to 4 years
Abstract
Objective: Using the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria to diagnose gestational diabetes mellitus (GDM), the association between GDM and offspring body mass index (BMI) gains in early childhood in China remains unclear. We aimed to assess the association between GDM diagnosed by the IADPSG criteria and BMI gain and the risk for overweight/obesity in offspring from 1 to 4 years. Methods: This prospective cohort study was based on the healthcare records data from the Medical Birth Registry in Xiamen, China. We included 10,412 mother-child pairs tested for GDM using IADPSG criteria. Results: A total of 1,786 (17.2%) offspring were exposed to GDM. The offspring exposed to GDM had higher mean BMI Z-score (difference, 0.07; 95% confidence interval [CI], 0.02 to 0.12) and risk for overweight/obesity (odds ratio [OR], 1.22; 95% CI, 1.06 to 1.40) compared to those unexposed to GDM from 1 to 4 years of age. However, after adjustment for maternal pre-pregnancy BMI (Model 2), these associations attenuated towards the null (difference in BMI Z-score, 0.02; 95% CI, -0.03 to 0.07; OR for overweight/obesity, 1.09; 95% CI, 0.95 to 1.25). Conclusion: The associations between GDM diagnosed using IADPSG criteria and BMI Z-score and the risk for overweight/obesity in offspring at the age of 1 to 4 years were largely explained by maternal pre-pregnancy BMI. Reducing the prevalence of childhood overweight and obesity in China should focus on maternal weight status before pregnancy, in addition to glycemia during pregnancy. Abbreviations: BMI = body mass index; CI = confidence interval; GDM = gestational diabetes mellitus; IADPSG = International Association of Diabetes and Pregnancy Study Groups; LGA = large for gestational age; MBRX = Medical Birth Registry in Xiamen; OGTT = oral glucose tolerance test; OR = odds ratio.
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Several recent cohort studies indicate that the association between GDM and increased BMI or risk of overweight in early childhood is attenuated or even null after adjustment for maternal pre-pregnancy BMI, indicating potential confounding effects attributable to maternal adiposity.
“Several recent cohort studies indicate that the association between GDM and increased BMI or risk of overweight in early childhood is attenuated or even null after adjustment for maternal pre-pregnancy BMI, indicating potential confounding effects attributable to maternal adiposity [84].”
From Maternal Overnutrition and Fetal Programming: Long-Term Metabolic, Cognitive, and Epigenetic Consequences (2026) · cites this paper as [84]
The literature shows heterogeneous findings regarding the association between gestational diabetes mellitus (GDM) and offspring obesity, particularly after adjustment for maternal pre-pregnancy BMI.
“We acknowledge that the literature shows heterogeneous findings regarding the association between gestational diabetes mellitus (GDM) and offspring obesity, particularly after adjustment for maternal pre-pregnancy BMI.”
From Maternal Overnutrition and Fetal Programming: Long-Term Metabolic, Cognitive, and Epigenetic Consequences (2026) · cites this paper as [84]
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- Authors
- Shi, X., Wang, D., Lin, M., Su, W., Wang, L., Xiao, F., Huang, P., Liu, W., Zeng, J., Song, H., & Li, X.
- Affiliations
- Xiamen University (CN)
- Corresponding author
- Li, Xuejun
- Venue
- Endocrine Practice
- Publisher
- Elsevier BV
- Published
- 2020-06
- Volume
- 26
- Issue
- 6
- Pages
- 619-626
- ISSN
- 1530-891X (ISSN-L)
- OpenAlex
- W3005661236
- Cited by
- 14
- References
- 34
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 1 · 2023: 3 · 2022: 3 · 2021: 2
- FWCI
- 1.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Endocrine Practice (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 › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- gestational diabetes mellitus, offspring body mass index, childhood overweight, childhood obesity, maternal pre-pregnancy BMI, IADPSG criteria, maternal weight status, early childhood growth
- MeSH terms
- Birth Weight, Child, Preschool, China, Female, Humans, Infant, Pregnancy, Prospective Studies, Risk Factors, Body Mass Index, Diabetes, Gestational
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