Maternal glycemia during pregnancy and offspring abdominal adiposity measured by MRI in the neonatal period and preschool years: The Growing Up in Singapore Towards healthy Outcomes (GUSTO) prospective mother–offspring birth cohort study

Abstract

<jats:title>ABSTRACT</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Gestational diabetes is associated with unfavorable body fat distribution in offspring. However, less is known about the effects across the range of maternal gestational glycemia on offspring abdominal adiposity (AA) in infancy and early childhood.</jats:p> </jats:sec> <jats:sec> <jats:title>Objectives</jats:title> <jats:p>This study determined the association between gestational glycemia and offspring AA measured by MRI in the neonatal period and during the preschool years.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Participants were mother–offspring pairs from the GUSTO (Growing Up in Singapore Towards healthy Outcomes) prospective cohort study. Children who underwent MRI within 2 wk postdelivery (n = 305) and/or at preschool age, 4.5 y (n = 273), and whose mothers had a 2-h 75-g oral-glucose-tolerance test (OGTT) at 26–28 weeks of gestation were included. AA measured by adipose tissue compartment volumes—abdominal superficial (sSAT), deep subcutaneous (dSAT), and internal (IAT) adipose tissue—was quantified from MRI images.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Adjusting for potential confounders including maternal prepregnancy BMI, each 1-mmol/L increase in maternal fasting glucose was associated with higher SD scores for sSAT (0.66; 95% CI: 0.45, 0.86), dSAT (0.65; 95% CI: 0.44, 0.87), and IAT (0.64; 95% CI: 0.42, 0.86) in neonates. Similarly, each 1-mmol/L increase in 2-h OGTT glucose was associated with higher neonatal sSAT (0.11; 95% CI: 0.03, 0.19) and dSAT (0.09; 95% CI: 0.00, 0.17). These associations were stronger in female neonates but only persisted in girls between fasting glucose, and sSAT and dSAT at 4.5 y.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>A positive association between maternal glycemia and neonatal AA was observed across the whole range of maternal mid-gestation glucose concentrations. These findings may lend further support to efforts toward optimizing maternal hyperglycemia during pregnancy. The study also provides suggestive evidence on sex differences in the impact of maternal glycemia, which merits further confirmation in other studies.</jats:p> <jats:p>This trial was registered at clinicaltrials.gov as NCT01174875.</jats:p> </jats:sec>

The association of maternal gestational hyperglycemia with breastfeeding duration and markers of milk production

“…It is not immediately clear why elevated FPG, but not 2hPG, is associated with early cessation of breastfeeding. A possible reason lies in the different pathophysiological mechanisms underlying FPG vs 2hPG which result in different metabolic abnormalities (18,19); this is supported by data from our cohort as FPG appears to exert a greater and more sustained influence on child growth and adiposity than 2hPG (21,49). We are unaware of other studies that have examined the association of FPG and breastfeeding duration.…”

Myo-Inositol Moderates Glucose-Induced Effects on Human Placental 13C-Arachidonic Acid Metabolism

“…In contrast with prior exposure to higher maternal fasting glycemia myo-inositol treatment generally increased 13 C-AA phospholipids (dots above y =0) ( Figure 4 , column 2). The association crossed the x axis around a fasting glycemia level of 4.4–4.5 mM, which is the median concentration in the general obstetric population [ 39 ]. Since endogenous phospholipids were lower with increasing fasting glycemia exposure ( Figure 2 C), this suggests that myo-inositol could act to bring AA-phospholipids towards physiological means, thus moderating AA placental metabolism.…”

Overweight-Obesity And Glucose Intolerance In Offspring Of Indian Diabetic Mothers

“…We observed the effects predominantly in males. European studies have reported increased adiposity in both sexes or restricted to males [27] . It would be interesting to explore the sex differences further.…”

“…The only comparable Indian follow up study (the Parthenon Cohort) made serial anthropometric measurements in ODM and ONDM and found that the offspring of diabetic mothers weighed more at birth, with a 'catch-down' in infancy and a rebound in early childhood, especially in girls (13,14). In contrast, European studies have reported increased adiposity in both sexes or restricted to boys (29). It would be interesting to explore this further.…”