Maternal and Child Health Journal

, Volume 20, Issue 8, pp 1559–1568 | Cite as

Impact of Maternal Glucose and Gestational Weight Gain on Child Obesity over the First Decade of Life in Normal Birth Weight Infants

  • Teresa A. Hillier
  • Kathryn L. Pedula
  • Kimberly K. Vesco
  • Caryn  E.S. Oshiro
  • Keith K. Ogasawara
Article

Abstract

Objective To determine, among children with normal birth weight, if maternal hyperglycemia and weight gain independently increase childhood obesity risk in a very large diverse population. Methods Study population was 24,141 individuals (mothers and their normal birth weight offspring, born 1995–2003) among a diverse population with universal GDM screening [50-g glucose-challenge test (GCT); 3 h. 100 g oral glucose tolerance test (OGTT) if GCT+]. Among the 13,037 full-term offspring with normal birth weight (2500–4000 g), annual measured height/weight was ascertained between ages 2 and 10 years to calculate gender-specific BMI-for-age percentiles using USA norms (1960–1995 standard). Results Among children who began life with normal birth weight, we found a significant trend for developing both childhood overweight (>85 %ile) and obesity (>95 %ile) during the first decade of life with both maternal hyperglycemia (normal GCT, GCT+ but no GDM, GDM) and excessive gestational weight gain [>40 pounds (18.1 kg)]; p < 0.0001 for both trends. These maternal glucose and/or weight gain effects to imprint for childhood obesity in the first decade remained after adjustment for potential confounders including maternal age, parity, as well as pre-pregnancy BMI. The attributable risk (%) for childhood obesity was 28.5 % (95 % CI 15.9–41.1) for GDM and 16.4 % (95 % CI 9.4–23.2) for excessive gestational weight gain. Conclusions for Practice Both maternal hyperglycemia and excessive weight gain have independent effects to increase childhood obesity risk. Future research should focus on prevention efforts during pregnancy as a potential window of opportunity to reduce childhood obesity.

Keywords

Childhood obesity Metabolic imprinting Gestational weight gain Hyperglycemia GDM Normal birth weight 

References

  1. 1.
    Aerts, L., & Van Assche, F. A. (2006). Animal evidence for the transgenerational development of diabetes mellitus. International Journal of Biochemistry & Cell Biology, 38(5–6), 894–903.CrossRefGoogle Scholar
  2. 2.
    American College of Obstetricians and Gynecologists. (2013). Practice bulletin No. 137: Gestational diabetes mellitus. Obstet Gynecol, 122(2 Pt), 406–416.Google Scholar
  3. 3.
    Berends, L. M., & Ozanne, S. E. (2012). Early determinants of type-2 diabetes. Best Practice & Research Clinical Endocrinology & Metabolism, 26(5), 569–580.CrossRefGoogle Scholar
  4. 4.
    Catalano, P. M., Farrell, K., Thomas, A., Huston-Presley, L., Mencin, P., de Mouzon, S. H., et al. (2009). Perinatal risk factors for childhood obesity and metabolic dysregulation. American Journal of Clinical Nutrition, 90(5), 1303–1313.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Centers for Disease Control and Prevention (CDC). (2009). PedNSS Health Indicators. http://www.cdc.gov/pednss/what_is/pednss_health_indicators.htm#birthweight. Accessed 25 Jan 2016.
  6. 6.
    Crozier, S. R., Robinson, S. M., Borland, S. E., Godfrey, K. M., Cooper, C., & Inskip, H. M. (2009). Do women change their health behaviours in pregnancy? Findings from the Southampton Women’s Survey. Paediatric and Perinatal Epidemiology, 23(5), 446–453.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Division of Nutrition and Physical Activity: Research to Practice Series No.4. (2007). Does breastfeeding reduce the risk of pediatric oveweight? http://www.cdc.gov/nccdphp/dnpa/nutrition/pdf/breastfeeding_r2p.pdf. Accessed 25 Jan 2016.
  8. 8.
    Frias, A. E., & Grove, K. L. (2012). Obesity: A transgenerational problem linked to nutrition during pregnancy. Seminars in Reproductive Medicine, 30(6), 472–478.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Gillman, M. W. (2005). Developmental origins of health and disease. New England Journal of Medicine, 353(17), 1848–1850.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Gillman, M. W., Oakey, H., Baghurst, P. A., Volkmer, R. E., Robinson, J. S., & Crowther, C. A. (2010). Effect of treatment of gestational diabetes mellitus on obesity in the next generation. Diabetes Care, 33(5), 964–968.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Hillier, T. A., Pedula, K. L., Schmidt, M. M., Mullen, J. A., Charles, M. A., & Pettitt, D. J. (2007). Childhood obesity and metabolic imprinting: The ongoing effects of maternal hyperglycemia. Diabetes Care, 30(9), 2287–2292.CrossRefPubMedGoogle Scholar
  12. 12.
    Hillier, T. A., Pedula, K. L., Vesco, K. K., Schmidt, M. M., Mullen, J. A., LeBlanc, E. S., et al. (2008). Excess gestational weight gain: Modifying fetal macrosomia risk associated with maternal glucose. Obstetrics and Gynecology, 112(5), 1007–1014.CrossRefPubMedGoogle Scholar
  13. 13.
    Institute of Medicine of the National Academies. (2009). Weight Gain During Pregnancy: Reexamining the Guidelines. Report Brief, May 2009. Internet. http://www.iom.edu/CMS/3788/48191/68004/68230.aspx. Accessed 25 January 2016.
  14. 14.
    James-Todd, T. M., Karumanchi, S. A., Hibert, E. L., Mason, S. M., Vadnais, M. A., Hu, F. B., et al. (2013). Gestational age, infant birth weight, and subsequent risk of type 2 diabetes in mothers: Nurses’ Health Study II. Preventing Chronic Disease, 10, E156.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Johnsson, I. W., Haglund, B., Ahlsson, F., & Gustafsson, J. (2014). A high birth weight is associated with increased risk of type 2 diabetes and obesity. Pediatric Obesity Google Scholar
  16. 16.
    Klein, J. D., & Dietz, W. (2010). Childhood obesity: The new tobacco. Health Affairs (Millwood), 29(3), 388–392.CrossRefGoogle Scholar
  17. 17.
    Kleinbaum, D. G., Kupper, L., & Morgenstern, H. (1982). Epidemiologic research: principles and quantitative methods. London: Wiley.Google Scholar
  18. 18.
    Kuczmarski, R. J., Ogden, C. L., Guo, S. S., Grummer-Strawn, L. M., Flegal, K. M., Mei, Z., et al. (2002a). 2000 CDC growth charts for the United States: Methods and development. Vital and Health Statistics, 11(246), 1–190.Google Scholar
  19. 19.
    Kuczmarski, R. J., Ogden, C. L., Guo, S. S., Grummer-Strawn, L. M., Flegal, K. M., & Mei, Z. et al. (2002b). 2000 CDC growth charts for the United States: Methods and development. National Center for Health Statistics. Vital and Health Statistics 11 (246). http://www.cdc.gov/nchs/data/series/sr_11/sr11_246.pdf. Accessed 25 Jan 2016.
  20. 20.
    Landon, M. B., Rice, M. M., Varner, M. W., Casey, B. M., Reddy, U. M., Wapner, R. J., et al. (2015). Mild gestational diabetes mellitus and long-term child health. Diabetes Care, 38(3), 445–452.CrossRefPubMedGoogle Scholar
  21. 21.
    Lau, C., Rogers, J. M., Desai, M., & Ross, M. G. (2011). Fetal programming of adult disease: Implications for prenatal care. Obstetrics and Gynecology, 117(4), 978–985.CrossRefPubMedGoogle Scholar
  22. 22.
    Lee, E., Wei, L., Amato, D., & Leurgans, S. (1992). Cox-Type regression analysis for large numbers of small groups of correlated failure time observations. In Survival analysis: state of the art Nato science, Vol. 211 (pp. 237–247). Berlin: Springer.Google Scholar
  23. 23.
    Ludwig, D. S., & Currie, J. (2010). The association between pregnancy weight gain and birthweight: A within-family comparison. Lancet, 376(9745), 984–990.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Ludwig, D. S., Rouse, H. L., & Currie, J. (2013). Pregnancy weight gain and childhood body weight: A within-family comparison. PLoS Medicine, 10(10), e1001521.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Lustig, R. H. (2001). The neuroendocrinology of childhood obesity. Pediatric Clinics of North America, 48(4), 909–930.CrossRefPubMedGoogle Scholar
  26. 26.
    Mayer-Davis, E. J., Rifas-Shiman, S. L., Zhou, L., Hu, F. B., Colditz, G. A., & Gillman, M. W. (2006). Breast-feeding and risk for childhood obesity: does maternal diabetes or obesity status matter? Diabetes Care, 29(10), 2231–2237.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Mission, J. F., Marshall, N. E., & Caughey, A. B. (2013). Obesity in pregnancy: A big problem and getting bigger. Obstetrical & Gynecological Survey, 68(5), 389–399.CrossRefGoogle Scholar
  28. 28.
    Pettitt, D. J., & Knowler, W. C. (1998). Long-term effects of the intrauterine environment, birth weight, and breast-feeding in Pima Indians. Diabetes Care 21 Supplementary, 2(1), B138–B141.Google Scholar
  29. 29.
    Pham, M. T., Brubaker, K., Pruett, K., & Caughey, A. B. (2013). Risk of childhood obesity in the toddler offspring of mothers with gestational diabetes. Obstetrics and Gynecology, 121(5), 976–982.CrossRefPubMedGoogle Scholar
  30. 30.
    Sridhar, S. B., Darbinian, J., Ehrlich, S. F., Markman, M. A., Gunderson, E. P., Ferrara, A., et al. (2014). Maternal gestational weight gain and offspring risk for childhood overweight or obesity. American Journal of Obstetrics and Gynecology, 211(3), 259.e1-8.CrossRefPubMedGoogle Scholar
  31. 31.
    Tanner, J. (1987). Catch-up and catch-down growth: A review Growth Genetics and Hormones. Growth Genetics and Hormones, 3(4), 8–11.Google Scholar
  32. 32.
    The HAPO Study Cooperative Research Group. (2008). Hyperglycemia and adverse pregnancy outcomes. New England Journal of Medicine, 358(19), 1991–2002.CrossRefGoogle Scholar
  33. 33.
    Tie, H. T., Xia, Y. Y., Zeng, Y. S., Zhang, Y., Dai, C. L., Guo, J. J., et al. (2014). Risk of childhood overweight or obesity associated with excessive weight gain during pregnancy: A meta-analysis. Archives of Gynecology and Obstetrics, 289(2), 247–257.CrossRefPubMedGoogle Scholar
  34. 34.
    Vignini, A., Raffaelli, F., Cester, A., Iannilli, A., Cherubini, V., Mazzanti, L., et al. (2012). Environmental and genetical aspects of the link between pregnancy, birth size, and type 2 diabetes. Current Diabetes Review, 8(3), 155–161.CrossRefGoogle Scholar
  35. 35.
    Waterland, R. A., & Garza, C. (1999). Potential mechanisms of metabolic imprinting that lead to chronic disease. American Journal of Clinical Nutrition, 69(2), 179–197.PubMedGoogle Scholar
  36. 36.
    Wattez, J. S., Delahaye, F., Lukaszewski, M. A., Risold, P. Y., Eberle, D., Vieau, D., et al. (2013). Perinatal nutrition programs the hypothalamic melanocortin system in offspring. Hormone and Metabolic Research, 45(13), 980–990.CrossRefPubMedGoogle Scholar
  37. 37.
    Williams, S., Davie, G., & Lam, F. (1999). Predicting BMI in young adults from childhood data using two approaches to modelling adiposity rebound. International Journal of Obesity and Related Metabolic Disorders, 23(4), 348–354.CrossRefPubMedGoogle Scholar
  38. 38.
    Williams, S. M. (2005). Weight and height growth rate and the timing of adiposity rebound. Obesity Research, 13(6), 1123–1130.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Teresa A. Hillier
    • 1
    • 2
  • Kathryn L. Pedula
    • 1
  • Kimberly K. Vesco
    • 1
  • Caryn  E.S. Oshiro
    • 2
  • Keith K. Ogasawara
    • 3
  1. 1.Center for Health ResearchKaiser Permanente NorthwestPortlandUSA
  2. 2.Center for Health ResearchKaiser Permanente HawaiiHonoluluUSA
  3. 3.Department of Obstetrics and GynecologyKaiser Permanente HawaiiHonoluluUSA

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