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Gestational diabetes and cardiovascular risk factors in the offspring: results from a cross-sectional study
A Beyerlein1, I Nehring, A Schaffrath Rosario
1Ludwig-Maximilians University of Munich, Institute of Social Paediatrics and Adolescent Medicine, Division of Epidemiology, Munich, Germany. andreas.beyerlein@med.uni-muenchen.de
Insights
Gestational diabetes mellitus (GDM) in mothers does not significantly impact offspring cardiovascular health. Maternal overweight, not GDM, appears to be the primary factor influencing children's body composition.
Area of Science:
- Pediatric Endocrinology
- Maternal-Fetal Medicine
- Cardiovascular Epidemiology
Background:
- The link between gestational diabetes mellitus (GDM) and offspring cardiovascular disease (CVD) risk factors requires further clarification.
- Maternal overweight may confound the association between GDM and offspring overweight.
Purpose of the Study:
- To investigate the association between GDM and CVD risk factors in offspring.
- To determine if maternal body mass index (BMI) confounds the GDM-offspring relationship.
Main Methods:
- Analysis of data from 12,542 children (aged 3-17) in the German KiGGS study.
- Linear and logistic regression models were used to assess offspring body composition, blood pressure, HbA1c, and cholesterol.
- Models were adjusted for maternal BMI to control for confounding effects.
Main Results:
- GDM prevalence was 2.2%. Unadjusted analyses showed a weak association between GDM and offspring BMI standard deviation scores (SDS).
- After adjusting for maternal BMI, this association diminished significantly (BMI SDS: 0.07).
- No significant effects of GDM on offspring blood pressure or cholesterol levels were observed.
Conclusions:
- GDM does not appear to have a substantial impact on offspring cardiovascular risk factors like blood pressure or cholesterol.
- The observed association between GDM and offspring body composition is largely explained by maternal BMI.
Background:
While the association of gestational diabetes mellitus and abnormal glucose tolerance is beyond doubt, its associations with other cardiovascular disease risk factors in the offspring are less clearly established. Some of these associations, in particular overweight in the offspring, might be confounded by maternal overweight.
Methods:
Data on 12,542 children in the age of 3-17 years with full information about gestational diabetes mellitus and maternal BMI were available from the German nationwide KiGGS study. We calculated linear and logistic regression models for measurements of body composition, blood pressure, HbA(1c) and cholesterol values in the offspring with gestational diabetes mellitus as the explanatory variable, with and without adjustment for maternal BMI.
Results:
The prevalence of gestational diabetes mellitus in the dataset was 2.2%. Unadjusted regression analyses suggested weak positive effects of gestational diabetes mellitus on body composition measurements [e.g. a mean increase in BMI standard deviation scores (SDS) of 0.17 units (95% confidence interval: 0.03, 0.30)]. After adjustment for maternal BMI, the observed associations almost disappeared [e.g. BMI SDS: 0.07 (-0.06, 0.20)]. With respect to blood pressure and cholesterol, no potential effects of gestational diabetes mellitus were observed in both unadjusted and adjusted models.
Conclusion:
Gestational diabetes mellitus does not appear to have a relevant effect on cardiovascular disease correlates such as blood pressure or cholesterol levels in children, and the potential effect of gestational diabetes mellitus on body composition seems to be widely explainable by maternal BMI.
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