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Obesity Studies
Maternal postload 1-hour glucose level during pregnancy and offspring’s overweight/obesity status in preschool age
  1. Xiulin Shi1,2,
  2. Peiying Huang1,2,
  3. Liying Wang1,2,
  4. Wei Lu1,2,
  5. Weijuan Su1,2,
  6. Bing Yan1,2,
  7. Changqin Liu1,2,
  8. Fangsen Xiao1,2,
  9. Haiqu Song1,2,
  10. Mingzhu Lin1,2,
  11. Xuejun Li1,2
  1. 1Xiamen Diabetes Institute, Xiamen, China
  2. 2Department of Endocrinology and Diabetes, Xiamen University and Fujian Medical University Affiliated First Hospital, Xiamen, China
  1. Correspondence to Dr Xuejun Li; xmlixuejun{at}163.com

Abstract

Background Childhood obesity is associated with adverse outcomes such as metabolic syndrome, diabetes, and cardiovascular diseases in adulthood. Identifying risk factors related to excessive adiposity in early childhood is of great importance for obesity intervention. The results of studies for associations between maternal with gestational diabetes and offspring obesity are conflicting. Nonetheless, the association of maternal glucose across a spectrum of glucose values with childhood adiposity outcomes is less clear.

Aim To assess the association of maternal glucose across a spectrum of glucose values with childhood adiposity at age 5 years.

Methods A population-based cohort study was conducted between 2011 and 2018. Using the healthcare records data were from the Medical Birth Registry in Xiamen, China. The primary outcome was offspring obese/obesity. Primary predictors were maternal oral glucose tolerance test values during pregnancy.

Results 6090 mother–child pairs were analyzed. The mean age of the children at follow-up was 5.2 years. At multiple logistic regression, after adjustment for variables, including maternal pre-pregnancy body mass index (BMI), birth weight of offspring, and insulin therapy, ORs for offspring overweight/obesity were 1.13 (95% CI 0.90 to 1.42) for maternal fasting glucose levels, 1.12 (95% CI 1.04 to 1.22) for 1-hour glucose, and 1.04 (95% CI 0.95 to 1.14) for 2-hour glucose. The adjusted association of offspring BMI Z-score with maternal 1-hour glucose level remained significant. There were no significant associations between BMI Z-score and maternal fasting glucose and 2-hour glucose level. Exploratory sex-specific analyses indicated generally consistent associations for boys and girls.

Conclusion Maternal postload 1-hour glucose across a spectrum of glucose values during pregnancy was an independent risk for offspring weight gain at age 5 years, indicating the importance of screen and management of maternal 1-hour glucose level, except for fasting glucose and 2-hour glucose level during pregnancy in order to prevent offspring weight gain in early childhood.

  • obesity
  • offspring
  • gestational diabetes mellitus
  • body mass index
https://creativecommons.org/licenses/by/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/bmjdrc-2019-000738

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    Footnotes

    • XS and PH contributed equally.

    • Contributors XS, ML, and XL designed the study. PH and LW designed the clinical questionnaire. WL, WS, BY, FX, HS, and CL collated the data. XS performed statistical data analyses. XL, ML, and XS contributed to drafting the manuscript. All authors reviewed and edited the manuscript to produce the final version.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval The study was approved by the Ethics Committee of the First Affiliated Hospital of Xiamen University (KYH2018-007).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request.