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Abnormal glucose tolerance during pregnancy in Pima Indian women. Long-term effects on offspring
D J Pettitt1, P H Bennett, M F Saad
1Diabetes and Arthritis Epidemiology Section, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ 85014.
Insights
Maternal gestational diabetes significantly increases offspring
Area of Science:
- Endocrinology
- Metabolic Health
- Perinatal Medicine
Background:
- Gestational diabetes mellitus (GDM) affects maternal and fetal health.
- Long-term health outcomes for offspring exposed to GDM require further investigation.
Purpose of the Study:
- To examine the long-term effects of abnormal glucose tolerance during pregnancy on offspring.
- To identify specific predictors of offspring metabolic health outcomes.
Main Methods:
- Study population: 552 Pima Indian offspring aged 5-24 years.
- Assessment of offspring: insulin resistance, obesity, and glucose tolerance.
- Statistical analysis: controlling for confounding factors and examining maternal glucose levels as predictors.
Main Results:
- Offspring of mothers with abnormal glucose tolerance exhibited earlier onset of fasting hyperinsulinemia (insulin resistance) and increased obesity.
- Higher maternal 2-hour postload glucose concentrations during pregnancy predicted higher offspring diabetes prevalence (OR=162).
- Maternal glucose levels during pregnancy significantly predicted offspring glucose levels (P=0.011).
Conclusions:
- Metabolic abnormalities during pregnancy have lasting adverse effects on offspring, including insulin resistance, obesity, and diabetes.
- These findings suggest a potential intergenerational transmission of metabolic risk.
- Early detection and management of glucose intolerance during pregnancy are crucial for offspring health.
Abstract:
The long-term effects on offspring of abnormal glucose tolerance detected during pregnancy were examined in 552 Pima Indian offspring 5-24 yr of age. Fasting hyperinsulinemia, presumably reflecting increased insulin resistance, occurred at an earlier age in the offspring of women who had abnormal glucose tolerance during pregnancy, and these offspring were more obese and had higher rates of abnormal glucose tolerance. When confounding factors were controlled, a 1 mM higher 2-h postload glucose concentration during pregnancy resulted in a significantly higher prevalence of diabetes in the offspring (odds ratio = 162). Maternal 2-h glucose concentration during pregnancy was also a significant predictor of glucose concentration during pregnancy in the offspring (P = 0.011). Thus, the metabolic abnormalities associated with the diabetic pregnancy result in long-term effects on the offspring, including insulin resistance, obesity, and diabetes, which in turn may contribute to transmission of risk for developing the same problems in the next generation.