Risks of overweight in the offspring of women with gestational diabetes at different developmental stages: A meta‐analysis with more than half a million offspring

Abstract

We conducted a meta-analysis to evaluate the association of maternal gestational diabetes mellitus (GDM) and offspring overweight from birth to adulthood, and to assess the effects of lifestyle interventions in women with GDM on this risk of offspring overweight. We identified literature from PubMed and 12 other electronic databases and retrieved relevant literature published before October 20, 2020. Random-effects model analysis was used to calculate relative risks (RRs) of overweight and weighted mean differences of body mass index among children stratified into different developmental stages. Forty-nine cohort studies (n = 559,377) and four randomized controlled trials (n = 1277) were included. We found that offspring of women with GDM were at an increased risk for overweight with age, from 1.14 (95% confidence interval [CI]: 1.06-1.22) under 5 years, 1.37 (95% CI: 1.31-1.44) at 5 to <10 years, 2.00 (95% CI: 1.79-2.23) at 10 to <18 years, to 2.05 (95% CI: 1.65-2.55) over 18 years of age (p < 0.05 for differences among groups). However, it was not observed that lifestyle interventions for GDM decreased the elevated overweight risk (RR: 0.94, 95% CI: 0.80-1.11, I 2 = 0.0%). These findings highlight the need for adopting an active and healthy lifestyle in this high-risk group.

The link between gestational diabetes and cardiovascular diseases: potential role of extracellular vesicles

“…Consistent with the hypothesis that GDM predisposes to CVD in the offspring, biomarkers of CVD risk (including blood lipid profile, obesity or overweight, alterations in blood pressure, and insulin resistance) are evident in children born of mothers with GDM [ 12 , 42 , 44 , 61 – 64 ]. Furthermore, children (3 years and older) born of pregnancies complicated by GDM have increased systolic and diastolic blood pressure [ 12 , 53 ], low plasma high-density lipoprotein (HDL) concentrations, hypertriglyceridemia [ 65 ], glucose intolerance [ 63 ], or insulin resistance [ 53 , 63 , 66 ], as well as increased adiposity [ 12 , 63 , 67 , 68 ].…”

Obesity and diabetes in pregnancy: a perfect storm for transgenerational health

“…16 There is increasing evidence associating GDM with the intergenerational transmission of poor health. Infants born to women with high BMI levels and GDM are more likely to be macrosomic at birth and to have overweight or obesity in childhood [17][18][19][20] and this adiposity persists into adolescence 17 increasing risk of diabetes as adults. 20 Maternal obesity and GDM increase the risk of cardiovascular diseases, 17,20 while maternal pre-pregnancy obesity increases the risk of developing respiratory diseases in infancy.…”

Interactions of CDKAL1 rs7747752 polymorphism and serum levels of L-carnitine and choline are related to increased risk of gestational diabetes mellitus

“…With increasing prevalence globally, gestational diabetes mellitus (GDM) has become one of the most common metabolic disorders in pregnancy [ 1 ]. GDM leads to adverse short- and long-term consequences for mothers and their offspring, including type 2 diabetes mellitus (T2DM) and cardiovascular diseases in the mothers, as well as macrosomia and childhood obesity in their offspring [ 2 – 4 ]. On the other hand, intensive management of GDM during pregnancy did not have a detectable effect on postpartum diabetes and prediabetes in the mothers [ 5 ] and childhood obesity in their offspring [ 6 , 7 ].…”