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Gestational diabetes detection thresholds and infant growth, nutrition, and neurodevelopment at 12-18 months: a
Francesca Amitrano1, Komal Manerkar1, Jane M Alsweiler2,3
1Liggins Institute, University of Auckland, Auckland, New Zealand.
Insights
Gestational diabetes (GDM) detection thresholds impact infant outcomes. Treated GDM or untreated GDM detected by lower criteria did not increase risks for infant obesity or cognitive issues.
Area of Science:
- Obstetrics and Gynecology
- Pediatric Nutrition
- Developmental Pediatrics
Background:
- Gestational diabetes mellitus (GDM) affects maternal and infant health.
- Optimal GDM detection thresholds are debated.
- Impact on infant development requires further investigation.
Purpose of the Study:
- To evaluate how different GDM detection thresholds influence infant growth, nutrition, and neurodevelopment.
- To compare outcomes between infants exposed to GDM under varying diagnostic criteria and treatment statuses.
Main Methods:
- Prospective cohort study within the GEMS trial.
- Pregnant women randomized to lower or higher GDM glycemic criteria.
- Infant outcomes assessed at 12-18 months: overweight/rapid gain, appetite, energy intake, cognition.
Main Results:
- Infants exposed to GDM detected by higher criteria or untreated GDM by lower criteria showed less rapid weight gain and potentially lower energy intake.
- No significant differences in infant appetite or cognitive scores were observed across groups.
- Infants exposed to treated GDM (lower criteria) were similar to controls.
Conclusions:
- GDM detection thresholds and treatment influence infant growth trajectories.
- Neither treated GDM nor untreated GDM detected by lower criteria increased infant obesity risk factors or adverse cognitive outcomes.
- Findings suggest GDM diagnostic criteria impact infant metabolic and developmental trajectories.
Objective:
To assess the impact of gestational diabetes(GDM) detection thresholds on infant growth, nutrition, and neurodevelopment at 12-18 months.
Design:
Prospective cohort study within the GEMS trial(ACTRN12615000290594), which randomized pregnant women to detection of GDM using lower or higher glycemic criteria. The main outcomes were overweight/rapid weight gain; food approach appetitive score; energy intake; cognitive z-score.
Result:
Compared to control infants, those exposed to GDM detected and treated by higher criteria or by lower but not higher criteria that was untreated, were less likely to have increased overweight/rapid weight gain, possibly with lower energy intake. There were no important differences in appetite and cognition. Infants exposed to GDM by lower but not higher criteria that was treated were similar to controls.
Conclusion:
Exposure to treated GDM or untreated GDM detected by lower but not higher criteria, was not associated with increased infant risk factors for obesity or adverse cognitive outcomes.
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