Factors affecting the growth of children till the age of three years with overweight whose mothers have diabetes mellitus: A population-based cohort study

Abstract

Background The prevalence of diabetes mellitus (DM) during pregnancy and childhood obesity is increasing worldwide. Factors affecting the growth of children with overweight whose mothers had DM are complicated and inconclusive. Few longitudinal studies have focused on the growth of infants with macrosomia born to mothers with DM and the factors influencing their overweight. This study explored risk factors for childhood overweight/obesity (OWOB) among children of mothers with DM. Perinatal, maternal socio-demographic, infant care, and maternal body weight characteristics as well as child growth until age 3 years were analyzed using a longitudinal design. Methods In total, 24,200 pairs of mothers and their children from the Taiwan Birth Cohort Study were included. Combined Taiwan Children Growth Curve report classifications were analyzed for infant growth at birth and at 6, 12, 18, 24, and 36 months old (m/o). A multiple logistic regression analysis with different model settings was used to assess factors affecting the growth of high birth weight children of mothers with diabetic mellitus (HODM). Results Children in the HODM group had a higher average body weight than did those in the non-DM group at different age stages. Relative to the non-DM group, weight gain in the HODM group was slower before 18 m/o but faster from 18 to 36 m/o, particularly after 24 m/o. Maternal DM was a major risk factor for childhood OWOB (odds ratio [OR]: 3.25–3.95). After adjustment for related confounders, the OR was 2.19–3.17. Maternal overweight or obesity and higher gestational weight gain were greater risk factors for childhood OWOB at 3 years old after adjusted maternal DM and other selected confounders (OR: 1.45 and 1.23, respectively). Breastfeeding until 6 m/o was a protective factor against childhood OWOB (OR: 0.95). The HODM and non-DM groups did not differ significantly in perinatal, maternal socio-demographic, or infant care characteristics. Conclusions Maternal DM is a major factor of childhood OWOB. Maternal body weight before and after pregnancy affects childhood OWOB, and this effect increases with the child’s age.

Overweight, obesity and excessive weight gain in pregnancy as risk factors for adverse pregnancy outcomes: A narrative review

“…Macrosomic infants weigh in excess of 4.5 kg at birth and this generally results in more caesarean sections as passage through the birth canal in a normal labour increases the risk of shoulder dystocia, bone fractures and subconjunctival haemorrhage 73 . GDM increases the risk of congenital heart defects 74 and infants born to women with GDM are at greater risk of childhood obesity 75 .…”

“…74 and infants born to women with GDM are at greater risk of childhood obesity. 75 The association between obesity and GDM is well documented. Systematic reviews and meta-analyses of case-control and cohort studies indicate that obesity increases risk by more than threefold, 76 and that excess visceral and central adiposity are greater risk factors than general obesity.…”

“…GDM increases the risk of congenital heart defects 74 . and infants born to women with GDM are at greater risk of childhood obesity 75 …”