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Aims/hypothesis Offspring of mothers with diabetes are at increased risk of metabolic disorders in later life. Increased offspring BMI is a plausible mediator. We performed a systematic review and meta-analysis of studies examining offspring BMI z score in childhood in relation to maternal diabetes. Methods Papers reporting BMI z scores for offspring of diabetic (all types, and pre-and during-pregnancy onset) and non-diabetic mothers were included. Citations were identified in PubMed; bibliographies of relevant articles were hand-searched and authors contacted for additional data where necessary. We compared offspring BMI z score with and without adjustment for maternal pre-pregnancy BMI. We performed fixed effect meta-analysis except where significant heterogeneity called for use of a random effects analysis. Results Data were available from nine studies. In the diabetic group unadjusted mean offspring BMI z score was 0.28 higher (all diabetic mothers vs controls (95% CI 0.09, 0.47; p=0.004; nine studies; offspring of diabetic mothers n=927, controls n=26,384) and with adjustment for maternal prepregnancy BMI, 0.07 higher (95% CI −0.15, 0.28; p=0.54; three studies; offspring of diabetic mothers n=244, controls n=11,206). There was no evidence of a difference in offspring BMI z score in relation to type of diabetes (gestational vs type 1, p=0.95).Conclusions/interpretation Maternal diabetes is associated with increased offspring BMI z score, although this is no longer apparent after adjustment for maternal prepregnancy BMI in the limited number of studies in which this is reported. Causal mediators of the effect of maternal diabetes on offspring outcomes remain to be established; we recommend that future research includes adjustment for maternal pre-pregnancy BMI.

Aims/hypothesis Offspring of diabetic mothers have increased risk of the metabolic syndrome in adulthood. Studies examining BP in offspring of diabetic mothers have conflicting conclusions. We performed a systematic review and metaanalysis of studies reporting offspring BP in children born to diabetic mothers. Methods Citations were identified in PubMed. Authors were contacted for additional data. Systolic and diastolic BP in offspring of diabetic mothers and controls were compared. Subgroup analysis of type of maternal diabetes and offspring sex were performed. Fixed-effects models were used, and random-effects models where significant heterogeneity was present. Meta-regression was used to test the relationship between offspring systolic BP and prepregnancy BMI. Results Fifteen studies were included in the review and 13 in the meta-analysis. Systolic BP was higher in offspring of diabetic mothers (mean difference 1.88 mmHg [95% CI 0.47, 3.28]; p00.009). Offspring of mothers with gestational diabetes had similar diastolic BP to controls, but higher systolic BP (1.39 mmHg [95% CI 0.00, 2.77]; p00.05); results for type 1 diabetes were inconclusive and there were no separate data available on offspring of type 2 diabetic mothers. Male offspring of diabetic mothers had higher systolic BP (2.01 mmHg [95% CI 0.93, 3.10]; p00.0003) and diastolic BP (1.12 mmHg [95% CI 0.36, 1.88]; p00.004) than controls; in female offspring there was no difference (systolic: 0.54 mmHg [95% CI −1.83, 2.90], p00.66; diastolic: 0.51 mmHg [95% CI −1.07, 2.09], p00.52). The correlation between offspring systolic BP and maternal prepregnancy BMI was not significant (p00.37). Conclusions/interpretation Offspring of diabetic mothers have higher systolic BP than controls. Differences related to sex and type of maternal diabetes require further investigation.

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