Maternal gestational diabetes and offspring’s obesity risk during late childhood, adolescent and early adulthood - Does sex matter?

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Authors

• S Li
• M Gillman
• Y Zhu
• E Yeung
• JE Chavarro
• CZ Yuan
• AE Field
• SA Missmer
• JL Mills
• FB Hu
• C Zhang

Abstract

Accumulating data from experimental studies suggest that offspring born from hyperglycemia in utero environment as exemplified in pregnancies complicated by gestational diabetes (GDM) may have increased risk of obesity later in their lives. However, data from epidemiological studies have been conflicting and the long-term impacts through adolescence and adulthood are unknown. Furthermore, it is unclear whether the trans-generational impact of GDM differs by sex of the offspring. We conducted a large prospective cohort study of 19,853 U.S. individuals (10,352 female and 9,501 male) from the Growing-Up Today Study and followed up through age 23-28 years by 2011. Obesity was defined using International Obesity Task Force criteria for children under age 18 and World Health Organization definition for age 18 or older. History of GDM was identified through self-reported questionnaires. We used generalized linear models and generalized estimating equations adjusting for pre-pregnancy body mass index (BMI), age, and major pre-pregnancy maternal factors. After multivariate adjustment, male offspring who were born to a GDM pregnancy had significantly higher BMI compared to those born to a normal pregnancy. Relative risks and its 95% Confidence Intervals for obesity was 1.57 (95% CI: 1.20-2.04) for male offspring, and elevated risk persisted across all age groups. Results were overall non-significant for female offspring. Hyperglycemia in utero environment may have a sex specific effect on obesity risk in the offspring; it is related to higher risk of obesity from childhood through early adulthood among male offspring, but not among females.

Scientific Focus Area: Epidemiology

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