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Gewichtsentwicklung von Kindern aus Schwangerschaften mit Gestationsdiabetes

Unter Berücksichtigung frühkindlicher Parameter

Course of weight gain in children from mothers with gestational diabetes

With special reference to early childhood parameters

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Zusammenfassung

Die somatische Entwicklung von Kindern aus Schwangerschaften mit Gestationsdiabetes (GDM) wurde unter Berücksichtigung neonataler Parameter und des Stillverhaltens untersucht. Bei 324 Kindern von Müttern mit GDM wurden Gewicht und Körpergröße bei einer Nachuntersuchung im Alter von 5,4±1,6 Jahren gemessen sowie die Angaben bei der Entbindung und aus den Vorsorgeheften im Alter von 6, 12 und 24 Monaten erfasst. Die Stilldauer wurde retrospektiv erfragt. Ein kindlicher BMI >90. Perzentile bzw. elterlicher BMI >30 kg/m2 wurden als Übergewicht definiert. Bei der Nachuntersuchung waren 92 von 324 Kindern (28,4%) übergewichtig, bei der Geburt 30,9%. Die Stilldauer betrug im Median 4,0 Monate. Der BMI-SDS bei der Geburt, nach 6, 12 und 24 Monaten sowie bei der Nachuntersuchung war signifikant erhöht (p<0,001). Bei der Nachuntersuchung waren 37,3% der nicht gestillten Kinder übergewichtig im Vergleich zu 32,5% und 22,0% der Kinder mit einer Stilldauer <3 bzw. >3 Monate (p=0,008). Bei Kindern von Müttern mit GDM besteht ein erhöhtes Risiko für Übergewicht bereits im frühen Kindesalter. Sowohl genetische als auch prä- und postnatale umwelt- und ernährungsbedingte Faktoren sind dabei von Bedeutung.

Abstract

The somatic development of children born to mothers who had experienced with gestational diabetes (GDM) during their pregnancies was investigated, with particular attention paid to neonatal parameters and to breastfeeding. Weight and height were measured at follow-up (FU) at age 5.4 (±1.6) years in 324 children born to women who had suffered GDM. Somatometric data recorded at delivery and on routine examinations at 6, 12, and 24 months were also ascertained. The duration of breastfeeding was recorded for each. A neonatal or childhood BMI above the 90th percentile and a parental BMI of over 30 kg/m2 were defined as overweight. At FU, 92 (28.4%) of the 324 children were overweight; at birth 30.9% had been overweight. The median duration of breastfeeding was 4.0 months. BMI-SDS was significantly higher (p<0.001) in these subjects at birth, at 6, 12, and 24 months and at FU than in the normal population. At FU, 37.3% of nonbreastfed children were overweight, as against to 32.5% of children breastfed for up to 3 months and 22.0% of children who had been breastfed for longer than 3 months (p=0.008). Children of mothers with GDM are at increased risk of overweight at birth and in early childhood. This seems to be due to pre- and postnatal factors affected by environment and nutrition and also to the genetic predisposition.

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Authors and Affiliations

  1. Diabeteszentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Janusz-Korczak-Allee 12, 30173 , Hannover, Deutschland

    O. Kordonouri & R. Hartmann

  2. Klinik für Geburtsmedizin, Vivantes Klinikum Neukölln, Berlin, Deutschland

    D. Passow, J. Pawliczak & U. Schäfer-Graf

  3. Klinik für Kinder- und Jugendmedizin, Vivantes Klinikum Neukölln, Berlin, Deutschland

    R. Rossi

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  1. O. Kordonouri
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  2. R. Hartmann
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  4. J. Pawliczak
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  5. R. Rossi
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  6. U. Schäfer-Graf
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Correspondence to O. Kordonouri.

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Kordonouri, O., Hartmann, R., Passow, D. et al. Gewichtsentwicklung von Kindern aus Schwangerschaften mit Gestationsdiabetes. Monatsschr Kinderheilkd 156, 671–676 (2008). https://doi.org/10.1007/s00112-007-1616-4

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