Mild gestational diabetes mellitus and long-term child health.

Landon, Mark B.; Murguia Rice, Madeline; Varner, Michael W.; Casey, Brian M.; Reddy, Uma M.; Wapner, Ronald J.; Rouse, Dwight J.; Biggio Jr., Joseph R.; Thorp, John M.; Chien, Edward K.; Saade, George; Peaceman, Alan M.; Blackwell, Sean C.; VanDorsten, J. Peter; Rice, Madeline Murguia; Biggio, Joseph R Jr; Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units (MFMU) Network

<bold>Objective: </bold>To evaluate whether treatment of mild gestational diabetes mellitus (GDM) confers sustained offspring health benefits, including a lower frequency of obesity. <bold>Research Design and Methods: </bold>Follow-up study of children (ages 5-10) of women enrolled in a multicenter trial of treatment versus no treatment of mild GDM. Height, weight, blood pressure, waist circumference, fasting glucose, fasting insulin, triglycerides, and HDL cholesterol were measured. <bold>Results: </bold>Five hundred of 905 eligible offspring (55%) were enrolled. Maternal baseline characteristics were similar between the follow-up treated and untreated groups. The frequencies of BMI ≥95th (20.8% and 22.9%) and 85th (32.6% and 38.6%) percentiles were not significantly different in treated versus untreated offspring (P = 0.69 and P = 0.26). No associations were observed for BMI z score, log waist circumference, log triglycerides, HDL cholesterol, blood pressure, or log HOMA-estimated insulin resistance (HOMA-IR). The effect of treatment was different by sex for fasting glucose and log HOMA-IR (P for interaction = 0.002 and 0.02, respectively) but not by age-group (5-6 and 7-10 years) for any outcomes. Female offspring of treated women had significantly lower fasting glucose levels. <bold>Conclusions: </bold>Although treatment for mild GDM has been associated with neonatal benefits, no reduction in childhood obesity or metabolic dysfunction in the offspring of treated women was found. However, only female offspring of women treated for mild GDM had lower fasting glucose.

GESTATIONAL diabetes; CHILDREN'S health; PREVENTION of childhood obesity; PEDIATRIC endocrinology; ENDOCRINE diseases; PREVENTION of obesity; BODY weight; FASTING; HEALTH status indicators; HIGH density lipoproteins; INSULIN; INSULIN resistance; LONGITUDINAL method; PRENATAL care; QUESTIONNAIRES; RESEARCH funding; SEX distribution; TRIGLYCERIDES; BODY mass index; WAIST circumference; PRENATAL exposure delayed effects; THERAPEUTICS

Diabetes Care, 2015, Vol 38, Issue 3, p445

0149-5992

Academic Journal

10.2337/dc14-2159