Rapid neonatal weight gain increases risk of childhood overweight in offspring of diabetic mothers

Abstract

Aim: Increased neonatal weight gain has been suggested as risk factor for later overweight. Offspring of diabetic mothers (ODM) have a long-term increased overweight risk. However, the role of early postnatal weight gain for later overweight has not been addressed so far in ODM. We investigated whether increased weight gain during the fi rst 4 months is related to later overweight in ODM. Methods: Determinants of childhood overweight and neonatal weight gain were analyzed in 152 ODM from the Kaulsdorf Cohort Study by MANOVA and regression analyses. Results: Independent of birth weight, weight gain during the fi rst 4 months was positively related to childhood relative body weight (P = 0.001). Each 100 g-increase in weight during this period increased overweight risk by 65 % (95 % CI: 10 -247 % ). ODM with rapid early weight gain had a more than six-fold increased risk of later overweight (OR: 6.77; 95 % CI: 1.36 -33.6). Early neonatal intake of breast milk from metabolically healthy mothers protected from rapid early weight gain (P = 0.03). Conclusions: Increased weight gain during the fi rst 4 months of life is a strong, independent risk factor for childhood overweight in ODM. Preventing nutritionally-induced rapid early weight gain in ODM might be a promising strategy to lower their long-term overweight risk.

Breastfeeding and growth during infancy among offspring of mothers with gestational diabetes mellitus: a prospective cohort study

“…Previous studies have shown that faster weight gain during the first 6 months of life may elevate future risk of overweight and obesity in children and adults in general (26,27), as well as for offspring of mothers with diabetes (28). Other, mostly retrospective studies of offspring of mothers with diabetes or with GDM, found that longer BF duration was associated with 25–50% lower odds of overweight and 50–76% lower odds of type 2 diabetes in older children at ages 9–14 years (2,10,11), or ages 2–8 years (6,8,12).…”

Post-weaning high-fat diet accelerates kidney injury, but not hypertension programmed by maternal diabetes

“…This phenomenon, termed perinatal programming, in which intrauterine events are associated with later adverse changes, has attracted much attention (1-3). Substantial epidemiologic data have also suggested that the offspring whose mothers were diabetic during pregnancy are susceptible to metabolic disturbances induced by postnatal overnutrition, as seen with high-fat diet (HFD) or with increased caloric intake in early life (1)(2)(3)(4).…”

“…This phenomenon, termed perinatal programming, in which intrauterine events are associated with later adverse changes, has attracted much attention (1-3). Substantial epidemiologic data have also suggested that the offspring whose mothers were diabetic during pregnancy are susceptible to metabolic disturbances induced by postnatal overnutrition, as seen with high-fat diet (HFD) or with increased caloric intake in early life (1)(2)(3)(4).Women who have diabetes during pregnancy and/or are obese and hyperinsulinemic are at risk of delivering macrosomic newborns (high birth weight), and both shortand long-term outcomes of macrosomic neonates are influenced by postnatal overnutrition (1-4). In high-birth-weight neonates, subsequent growth in infancy and risk of becoming obese or diabetic are directly and linearly linked-e.g., the higher the birth weight, the greater the risk of overweight and metabolic disturbances later in life (1-4).…”

“…Women who have diabetes during pregnancy and/or are obese and hyperinsulinemic are at risk of delivering macrosomic newborns (high birth weight), and both shortand long-term outcomes of macrosomic neonates are influenced by postnatal overnutrition (1)(2)(3)(4). In high-birth-weight neonates, subsequent growth in infancy and risk of becoming obese or diabetic are directly and linearly linked-e.g., the higher the birth weight, the greater the risk of overweight and metabolic disturbances later in life (1)(2)(3)(4).…”

“…In high-birth-weight neonates, subsequent growth in infancy and risk of becoming obese or diabetic are directly and linearly linked-e.g., the higher the birth weight, the greater the risk of overweight and metabolic disturbances later in life (1)(2)(3)(4). In contrast, pregnant women with severe, uncontrolled diabetes or diabetic complications, such as diabetic nephropathy and/or retinopathy, are at high risk of having a microsomic fetus (i.e., a fetus with intrauterine growth restriction (IUGR)) (5,6).…”