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Gestational diabetes and childhood asthma in a racially diverse US pregnancy cohort
Margaret A Adgent1,2, Tebeb Gebretsadik3, Jada Reedus1,4
1Division of General Pediatrics, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
Insights
Gestational diabetes increases a child's risk for developing asthma and wheeze. This study highlights a potential prenatal link between maternal health and childhood respiratory conditions.
Area of Science:
- Obstetrics and Gynecology
- Pediatrics
- Epidemiology
Background:
- Childhood asthma is a prevalent chronic condition with suspected prenatal origins.
- Gestational diabetes mellitus (GDM) can alter maternal physiology, potentially impacting fetal development and increasing the risk of childhood-onset diseases.
- The specific association between GDM and childhood asthma remains incompletely understood.
Purpose of the Study:
- To examine the relationship between gestational diabetes and the risk of wheeze and asthma in children around four years of age.
- To investigate this association within a diverse population in the United States.
Main Methods:
- A cohort of mother-child dyads was enrolled prenatally in the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) study.
- Gestational diabetes was identified through medical chart review.
- Child respiratory outcomes, including physician-diagnosed asthma, current wheeze, and current asthma, were assessed around age four using parent reports and medical data. Modified Poisson regression was employed for analysis, controlling for various maternal and infant factors.
Main Results:
- The study included 1107 women, with 6% diagnosed with gestational diabetes.
- Gestational diabetes was significantly associated with an increased risk of physician-diagnosed asthma (aRR: 2.13), current wheeze (aRR: 1.85), and current asthma (aRR: 2.01) at approximately four years of age.
- Prevalence rates for these outcomes were 14% for diagnosed asthma, 19% for current wheeze, and 16% for current asthma in the context of GDM.
Conclusions:
- Gestational diabetes is linked to a higher risk of asthma and wheeze in children.
- Further research is warranted to explore the underlying modifiable pathways that connect GDM to these respiratory outcomes in childhood.
Background:
Childhood asthma is a common chronic disease that likely has prenatal origins. Gestational diabetes alters maternal physiology and may influence fetal risk for childhood-onset disease. However, the association between gestational diabetes and child asthma is not well characterized.
Objective:
To investigate the association between gestational diabetes and wheeze/asthma at approximately 4 years of age in a racially diverse US cohort.
Methods:
We studied mother-child dyads enrolled prenatally in the Conditions Affecting Neurocognitive Development and Learning in Early Childhood study. Gestational diabetes was determined by medical chart review. At approximately 4 years of age, we assessed child respiratory outcomes including parent report of physician-diagnosed asthma (ever), current wheeze (symptoms within the past 12 months), and current asthma (physician diagnosis and/or medication or symptoms within the past 12 months). We used the modified Poisson regression to assess associations between gestational diabetes and child respiratory outcomes, adjusting for maternal age, race, prenatal smoking, pre-pregnancy body mass index, parity, asthma history, socioeconomic status, and infant sex.
Results:
Among 1107 women, 66% were African American/Black. Six percent (n = 62) had gestational diabetes documented during pregnancy. Gestational diabetes was associated with increased risk of physician-diagnosed asthma (adjusted risk ratio (RR) [95% Confidence Interval]: 2.13 [1.35, 3.38]; prevalence: 14%), current wheeze (RR: 1.85 [1.23, 2.78]; prevalence: 19%), and current asthma (RR: 2.01 [1.30, 3.10]; prevalence: 16%).
Conclusions:
Gestational diabetes was associated with increased risk of asthma and wheeze outcomes. Additional studies are needed to elucidate modifiable pathways underlying this association.
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