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Maternal postload 1-hour glucose level during pregnancy and offspring's overweight/obesity status in preschool age
Xiulin Shi1,2, Peiying Huang1,2, Liying Wang1,2
1Xiamen Diabetes Institute, Xiamen, China.
Insights
Maternal 1-hour glucose levels during pregnancy are linked to childhood obesity risk. Early screening and management of maternal 1-hour glucose can help prevent excessive weight gain in children.
Area of Science:
- Reproductive Health
- Pediatric Endocrinology
- Public Health
Background:
- Childhood obesity is a growing concern with long-term health implications, including metabolic syndrome and cardiovascular diseases.
- Identifying early risk factors for childhood adiposity is crucial for effective obesity interventions.
- Existing research on maternal gestational diabetes and offspring obesity shows conflicting results, and the impact of a wider spectrum of maternal glucose levels is unclear.
Purpose of the Study:
- To investigate the association between maternal glucose levels across a spectrum of values during pregnancy and offspring adiposity at age 5.
- To clarify the role of maternal glucose tolerance test results in predicting childhood obesity risk.
Main Methods:
- A population-based cohort study utilized healthcare records from the Medical Birth Registry in Xiamen, China (2011-2018).
- Analyzed data from 6090 mother-child pairs, with offspring adiposity (obesity/overweight) as the primary outcome.
- Maternal oral glucose tolerance test values during pregnancy were the primary predictors, with logistic regression adjusted for confounders like maternal BMI and birth weight.
Main Results:
- Maternal 1-hour postload glucose levels showed a significant association with offspring overweight/obesity (OR 1.12, 95% CI 1.04 to 1.22) after adjustments.
- Offspring BMI Z-score was significantly associated with maternal 1-hour glucose levels, but not fasting or 2-hour glucose levels.
- No significant associations were found between offspring BMI Z-score and maternal fasting or 2-hour glucose levels.
Conclusions:
- Maternal 1-hour glucose levels during pregnancy represent an independent risk factor for offspring weight gain by age 5.
- Screening and management of maternal 1-hour glucose levels, distinct from fasting and 2-hour levels, are important for preventing childhood obesity.
- These findings highlight the need for targeted interventions focusing on maternal glycemic control during pregnancy.
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.
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