In utero exposure to gestational diabetes and adiposity: does breastfeeding make a difference?

Area of Science:

• Reproductive health
• Pediatric endocrinology
• Metabolic disease research

Background:

• Gestational diabetes mellitus (GDM) in pregnancy may influence offspring's long-term metabolic programming.
• Maternal GDM is a potential risk factor for increased adiposity in children.
• The role of early infant feeding, particularly breastfeeding, in modifying GDM's metabolic effects on offspring requires investigation.

Purpose of the Study:

• To investigate the association between in utero exposure to GDM and offspring adiposity from infancy through adolescence.
• To determine if early infant feeding modifies the relationship between in utero GDM exposure and offspring adiposity.

Main Methods:

• Utilized the prospective Chinese birth cohort "Children of 1997" (n=7342).
• Employed generalized estimating equations with multiple imputation to assess body mass index (BMI) z-scores at different life stages.
• Adjusted for multiple covariates and analyzed the interaction between GDM exposure and infant feeding modes (formula, mixed, breastfed) in the first three months.

Main Results:

• In utero GDM exposure was associated with lower infant BMI z-scores but significantly higher BMI z-scores in childhood and adolescence.
• Early breastfeeding (first three months) did not alter the association between in utero GDM exposure and subsequent offspring BMI.
• No statistically significant interaction was found between GDM status and infant feeding mode on BMI z-scores.

Conclusions:

• Exposure to GDM in utero is linked to increased adiposity in offspring during childhood and adolescence.
• Breastfeeding in early infancy among mothers with GDM is not associated with increased offspring adiposity.
• Encouraging breastfeeding remains advisable for mothers with GDM, as it does not appear to exacerbate long-term adiposity risks.