Association between early introduction of fruit juice during infancy and childhood consumption of sweet-tasting foods and beverages among children exposed and unexposed to gestational diabetes mellitus in utero

Maternal gestational diabetes and infant feeding, nutrition and growth: a systematic review and meta-analysis

“…All the included studies were observational, with the majority being cohort studies; thirteen were prospective (19,37,(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54) , eleven were retrospective (20,(38)(39)(40)(41)(42)(43)(55)(56)(57)(58)(59) and one was a retrospective casecontrol study (60) (Table 1). All but three studies (38,44,45) were published after 2010.…”

“…GDM was diagnosed using a one-step 2-h 75 g oral glucose tolerance test in six studies (37,43,51,52,54,60) ; one-step 3-h oral glucose tolerance test in one study (45) ; 50 g polycose screen followed by 2-h 75 g oral glucose tolerance test in two studies (49,55) and 3-h oral glucose tolerance test in four studies (41,42,44,46,53) ; or by maternal report in six studies (39,40,50,(56)(57)(58) . Diagnostic criteria for GDM were unclear in six studies (19,20,38,47,48,59) .…”

“…No study had low risk of bias for all domains ( Table 2). Only seven studies adjusted for potential confounding (19,39,40,50,52,54,59) and nine studies were at high risk of bias due to possible confounding (20,38,43,(45)(46)(47)(48)53,60) . Seven studies had high risk of bias relating to ascertainment of exposures (38,39,42,47,48,50,59) because exposures were not measured prior to outcomes of interest or were not well defined (38,47,48,59) .…”

“…S5). Moreover, infants exposed to GDM compared with those not exposed to GDM had shorter duration of breast-feeding (months) (SMD −0•19, 95 % CI −0•26, −0•12; P < 0•00001, I 2 = 76 %; five studies, 9176 infants; very low-quality evidence) (19,20,38,40,50) (Table 3; online Supplementary Fig. S6).…”

“…For example, rats exposed to maternal diabetes in pregnancy demonstrate hyperinsulinaemia, and exposure to breast milk of dams with GDM has been shown to alter hypothalamic function, which may influence satiety centres and regulation of body weight and metabolism (17,18) . In humans, GDM has been associated with lower breast-feeding duration, early introduction of cows' milk (19,20) and greater weight gain in the first 3 months of life (21,22) .…”