Background: The metabolic outcome in adult life is known to be determined during fetal life. Prenatal poor nutrition also affects growth and maturation, formation of insulin resistance during childhood. Little is known about the effect of maternal gestational diabetes mellitus (GDM) on early metabolic and growth outcome of their children.
Objective and hypotheses: To investigate growth, glucose metabolism, and blood pressure in children of mothers with GDM by comparing healthy controls from non GDM mothers.
Method: Children of Seiiku birth cohort and GDM cohort are involved in this study (n=1125, 5 years old group: GDM 50 and non GDM 1 014, 9 years old group; GDM 14 and non GDM 97, male to female ratio =1). The auxological data (height, weight, BMI, waist circumference, blood pressure) and biochemical data (WBC, blood glucose, HbA1c, Glycoalbumin (GA), LCL-cholesterol, HDL-cholesterol, IGF1, insulin) were obtained at 5 and 9 years old. Statistical analysis was performed to determine significant difference among four groups (5GDM+, 5GDM−, 9GDM+, 9 GDM−).
Results: Height and height velocity were within normal range in all subjects. Obesity rate did not differ significantly, however, 9GDM+ group showed higher rate than the other groups. Waist circumference was significantly bigger in 5GDM+ than 5GDM- (52.5 vs 49.8 cm (mean), P<0.0001). Waist of 9GDM+ was bigger than 9GDM- (57.9 vs 55.3 cm), but not significant. Systolic blood pressure was significantly higher in 5GDM+ than in 5GDM−. HbA1c level was significantly high in 9GDM+ than in 9GDM−, and 5GDM− (Mean 5.3, 5.14, and 5.06% respectively). 5GDM+ showed HbA1c level at 5.2%, which was not significantly different from the other groups. On the other hand, GA, LDL-C, HDL-C showed no significant difference among groups. IGF1 level was significantly higher in 5GDM+ than 5GDM− (P<0.001).
Conclusion: Children born from GDM mothers had higher waist circumference and higher systolic blood pressure than controls at 5 years of age, and had higher HbA1c at 9 years old. Although there were no apparent diabetes, obesity, or hypertension, children from GDM mothers seem to be prone to metabolic derangement. Although there were no apparent diabetes, obesity, or hypertension, children from GDM mothers seems to be prone to metabolic derangement.
Funding: This work was supported by Research grant from Ministry of Health, labor and welfare, Japan (grant numbers Seiiku Research grant 2619).
01 - 03 Oct 2015
European Society for Paediatric Endocrinology