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Altered growth trajectory in children born to mothers with gestational diabetes mellitus and preeclampsia

Archives of Gynecology and Obstetrics volume 301, pages 151–159 (2020)Cite this article

Abstract

Purpose

Gestational diabetes mellitus (GDM) and preeclampsia are leading causes of mortality and morbidity in mothers and children. High childhood body mass index (BMI) is among their myriad of negative outcomes. However, little is known about the trajectory of the child BMI exposed to GDM and co-occurring preeclampsia from early to mid-childhood. This study examined the independent and joint impact of GDM and preeclampsia on childhood BMI trajectory.

Methods

A population-based sample of 356 mothers were recruited from OB/GYN clinics in New York. Their children were then followed annually from 18 to 72 months. Maternal GDM and preeclampsia status were obtained from medical records. Child BMI was calculated based on their height and weight at annual visits.

Results

Hierarchical Linear Modeling was used to evaluate the trajectories of child BMI exposed to GDM and preeclampsia. BMI trajectory by GDM decreased (t ratio = − 2.24, \(\beta =\)0.45, 95% CI − 0.05–0.95, p = 0.07), but the trajectory by preeclampsia increased over time (t ratio = 3.153,\(\beta =\)0.65, 95% CI 0.11–1.18, p = 0.002). Moreover, there was a significant interaction between the two (t ratio = −2.24, \(\beta =\)− 1.244, 95% CI 0.15–2.33, p = 0.02), such that the BMI of children born to mothers with both GDM and preeclampsia showed consistent increases over time.

Conclusions

GDM and preeclampsia could be used as a marker for childhood obesity risk and the identification of a high-risk group, providing potential early intervention. These findings highlight the importance of managing obstetric complications, as an effective method of child obesity prevention.

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References

  1. Hales CM, Carroll MD, Fryar CD et al (2017) Prevalence of obesity among adults and youth: United States, 2015–2016. NCHS Data Brief 288:1–8

    Google Scholar 

  2. Reilly JJ, Armstrong J, Dorosty AR et al (2005) Early life risk factors for obesity in childhood: cohort study. BMJ 330(7504):1357

    PubMed  PubMed Central  Google Scholar 

  3. Schaefer-Graf UM, Pawliczak J, Passow D et al (2005) Birth weight and parental BMI predict overweight in children from mothers with gestational diabetes. Diabetes Care 28(7):1745–1750

    PubMed  Google Scholar 

  4. Zhou T, Sun D, Li et al (2018) Prevalence and trends in gestational diabetes mellitus among women in the United States, 2006–2016. Diabetes 67(Suppl 1)

    Google Scholar 

  5. ACOG Committee on Obstetric Practice (2018) ACOG practice bulletin No. 190: gestational diabetes mellitus. Obstet Gynecol 131(2):e49–e64

    Google Scholar 

  6. DeSisto CL, Kim SY, Sharma AJ (2014) Prevalence estimates of gestational diabetes mellitus in the United States, pregnancy risk assessment monitoring system (prams). Prev Chronic Dis 11:E104

    PubMed  PubMed Central  Google Scholar 

  7. Dornhorst A, Paterson CM, Nicholls JSD et al (1992) High prevalence of gestational diabetes in women from ethnic minority groups. Diabet Med 9(9):820–825

    CAS  PubMed  Google Scholar 

  8. ACOG Committee on Obstetric Practice (2019) ACOG Practice bulletin No. 202: diagnosis and management of preeclampsia and eclampsia. Obstet Gynecol 133(1):e1–e25

    Google Scholar 

  9. Williams D (2011) Long-term complications of preeclampsia. Seminars in nephrology, vol 31. WB Saunders, Philadelphia, pp 111–122

    Google Scholar 

  10. Ornoy A (2011) Prenatal origin of obesity and their complications: gestational diabetes, maternal overweight and the paradoxical effects of fetal growth restriction and macrosomia. Reprod Toxicol 32(2):205–212

    CAS  PubMed  Google Scholar 

  11. Mitanchez D (2010) Foetal and neonatal complications in gestational diabetes: perinatal mortality, congenital malformations, macrosomia, shoulder dystocia, birth injuries, neonatal complications. Diabetes Metab 36(6):617–662

    CAS  PubMed  Google Scholar 

  12. Farahvar S, Walfisch A, Sheiner E (2019) Gestational diabetes risk factors and long-term consequences for both mother and offspring: a literature review. Expert Rev Endocrinol Metab 14(1):63–74

    CAS  PubMed  Google Scholar 

  13. Nomura Y, Marks DJ, Grossman B et al (2012) Exposure to gestational diabetes mellitus and low socioeconomic status: effects on neurocognitive development and risk of attention- deficit/hyperactivity disorder in offspring. Arch Pediatr Adolesc Med 166(4):337–343

    PubMed  PubMed Central  Google Scholar 

  14. Clausen TD, Mathiesen ER, Hansen T et al (2008) High prevalence of type 2 diabetes and pre-diabetes in adult offspring of women with gestational diabetes mellitus or type 1 diabetes: the role of intrauterine hyperglycemia. Diabetes Care 31(2):340–346

    PubMed  Google Scholar 

  15. Abokaf H, Shoham-Vardi I, Sergienko R et al (2018) In utero exposure to gestational diabetes mellitus and long term endocrine morbidity of the offspring. Diabetes Res Clin Prac 144:231–235

    CAS  Google Scholar 

  16. Reece EA, Leguizamón G, Wiznitzer A (2009) Gestational diabetes: the need for a common ground. Lancet 373(9677):1789–1797

    PubMed  Google Scholar 

  17. Cornier MA, Dabelea D, Hernandez TL et al (2008) The metabolic syndrome. Endocr Rev 29(7):777–822

    CAS  PubMed  PubMed Central  Google Scholar 

  18. Gillman MW, Rifas-Shiman S, Berkey CS et al (2003) Maternal gestational diabetes, birth weight, and adolescent obesity. Pediatrics 111(3):e221–e226

    PubMed  Google Scholar 

  19. Hillier TA, Pedula KL, Schmidt MM et al (2007) Childhood obesity and metabolic imprinting: the ongoing effects of maternal hyperglycemia. Diabetes Care 30(9):2287–2292

    PubMed  Google Scholar 

  20. Kamana KC, Shakya S, Zhang H (2015) Gestational diabetes mellitus and macrosomia: a literature review. Ann Nutr Metab 66(Suppl. 2):14–20

    Google Scholar 

  21. Ergaz Z, Avgil M, Ornoy A (2005) Intrauterine growth restriction—etiology and consequences: what do we know about the human situation and experimental animal models? Reprod Toxicol 20(3):301–322

    CAS  PubMed  Google Scholar 

  22. Barker DJ, Hales CN, Fall CHD et al (1993) Type 2 (non-insulin-dependent) diabetes mellitus, hypertension and hyperlipidaemia (syndrome X): relation to reduced fetal growth. Diabetologia 36(1):62–67

    CAS  PubMed  Google Scholar 

  23. Hod M, Diamant YZ (1992) The offspring of a diabetic mother–short-and long-range implications. Isr J Med Sci 28(2):81–86

    CAS  PubMed  Google Scholar 

  24. Ghulmiyyah L, Sibai B (2012) Maternal mortality from preeclampsia/eclampsia. Semin in Perinatol 36(1):56–59

    Google Scholar 

  25. Habli M, Levine RJ, Qian C et al (2007) Neonatal outcomes in pregnancies with preeclampsia or gestational hypertension and in normotensive pregnancies that delivered at 35, 36, or 37 weeks of gestation. AJOG 197(4):406.e1–406.e7

    Google Scholar 

  26. Masoura S, Kalogiannidis I, Margioula-Siarkou C et al (2012) Neonatal outcomes of late preterm deliveries with pre-eclampsia. Minerva Ginecol 64(2):109–115

    CAS  PubMed  Google Scholar 

  27. Powe CE, Ecker J, Rana S et al (2011) Preeclampsia and the risk of large-for-gestational-age infants. AJOG 204(5):425.e1–425.e6

    Google Scholar 

  28. Bramham K, Briley AL, Seed P et al (2011) Adverse maternal and perinatal outcomes in women with previous preeclampsia: a prospective study. AJOG 204(6):512.e1–512.e9

    Google Scholar 

  29. Saadat M, Nejad SM, Habibi G et al (2007) Maternal and neonatal outcomes in women with preeclampsia. Taiwan J of Obstet & Gynecol 46(3):255–259

    Google Scholar 

  30. Forest JC, Girouard J, Massé J (2005) Early occurrence of metabolic syndrome after hypertension in pregnancy. Obstet & Gynecol 105(6):1373–1380

    Google Scholar 

  31. Palti H, Rothschild E (1989) Blood pressure and growth at 6 years of age among offsprings of mothers with hypertension of pregnancy. Early Hum Dev 19(4):263–269

    CAS  PubMed  Google Scholar 

  32. Seidman DS, Laor A, Gale R et al (1991) Pre-eclampsia and offspring’s blood pressure, cognitive ability and physical development at 17-years-of-age. BJOG 98(10):1009–1014

    CAS  Google Scholar 

  33. Tenhola S, Rahiala E, Martikainen A et al (2003) Blood pressure, serum lipids, fasting insulin, and adrenal hormones in 12-year-old children born with maternal preeclampsia. The J of Clin Endocrinol & Metab 88(3):1217–1222

    CAS  Google Scholar 

  34. Davis EF, Lazdam M, Lewandowski AJ et al (2012) Cardiovascular risk factors in children and young adults born to preeclamptic pregnancies: a systematic review. Pediatrics 129(6):e1552–e1561

    PubMed  Google Scholar 

  35. Bos AF, Einspieler C, Prechtl HF (2001) Intrauterine growth retardation, general movements, and neurodevelopmental outcome: a review. Dev Med Child Neurol 43(1):61–68

    CAS  PubMed  Google Scholar 

  36. Tolsa CB, Zimine S, Warfield SK et al (2004) Early alteration of structural and functional brain development in premature infants born with intrauterine growth restriction. Pediatr Res 56(1):132–138

    PubMed  Google Scholar 

  37. Xiong X, Saunders LD, Wang FL et al (2001) Gestational diabetes mellitus: prevalence, risk factors, maternal and infant outcomes. Int J of Gynecol & Obstet 75(3):221–228

    CAS  Google Scholar 

  38. Li LJ, Aris IM, Su LL et al (2018) Effect of gestational diabetes and hypertensive disorders of pregnancy on postpartum cardiometabolic risk. Endocrin Connect 7(3):433–442

    CAS  Google Scholar 

  39. Kvehaugen AS, Andersen LF, Staff AC (2010) Anthropometry and cardiovascular risk factors in women and offspring after pregnancies complicated by preeclampsia or diabetes mellitus. Acta Obstet Gynecol Scand 89(11):1478–1485

    PubMed  Google Scholar 

  40. Finik J, Nomura Y (2017) Cohort profile: stress in pregnancy (SIP) study. Int J of Epidemiol 46(5):1388

    Google Scholar 

  41. Maas CJ, Hox JJ (2004) The influence of violations of assumptions on multilevel parameter estimates and their standard errors. Comput Stat Data Anal 15;46(3):427–440

    Google Scholar 

  42. Rolland-Cachera MF, Deheeger M, Bellisle F et al (1984) Adiposity rebound in children: a simple indicator for predicting obesity. Am J of Clin Nutr 39:129–135

    CAS  Google Scholar 

  43. Langer O, Levy J, Brustman L et al (1989) Glycemic control in gestational diabetes mellitus-how tight is tight enough: small for gestational age versus large for gestational age? AJOG 161(3):646–653

    CAS  Google Scholar 

  44. Berkey CS, Rockett HR, Field AE et al (2000) Activity, dietary intake, and weight changes in a longitudinal study of preadolescent and adolescent boys and girls. Pediatrics 105(4):e56

    CAS  PubMed  Google Scholar 

  45. Gunderson EP, Greenspan LC, Faith MS et al (2018) SWIFT Offspring Study Investigators. Breastfeeding and growth during infancy among offspring of mothers with gestational diabetes mellitus: a prospective cohort study. Pediatr Obes 13(8):492–504

    CAS  PubMed  PubMed Central  Google Scholar 

  46. Miehle K, Stepan H, Fasshauer M (2012) Leptin, adiponectin and other adipokines in gestational diabetes mellitus and pre-eclampsia. Clin Endocrinol 76(1):2–11

    CAS  Google Scholar 

Download references

Acknowledgements

The authors would like to thank the families for their participation, the Stress in Pregnancy laboratory staff at Queens College CUNY (especially Jackie Finik, Westar Zong, and Victoria Kuo), and the staff at the prenatal clinics and OB/GYN departments of Icahn School of Medicine at Mount Sinai and New York Presbyterian-Queens Hospital. This research work was supported by the National Institute of Mental Health under award number R01MH102729 and the Professional Staff Congress City University of New York grant to Y Nomura. The content of the manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Funding

This study was funded by the National Institute of Mental Health under award number R01MH102729 and the Professional Staff Congress City University of New York grant to Y Nomura.

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Authors and Affiliations

  1. Department of Psychology, Queens College, City University of New York, 65-30 Kissena Blvd, Flushing, NY, 11367, USA

    Sheow Yun Sie & Yoko Nomura

  2. Department of Psychology, Graduate Center, City University of New York, New York, USA

    Yonglin Huang, Karen Go & Yoko Nomura

  3. Department of Psychology, New Jersey City University, Jersey City, NJ, USA

    Wei Zhang

  4. Research Center for Child Mental Development and United Graduate School of Child Development, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan

    Kenji J. Tsuchiya

  5. Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine At Mount Sinai, New York, NY, USA

    Jianzhong Hu

  6. Department of Genetics and Genomic Sciences, Icahn School of Medicine At Mount Sinai, New York, NY, USA

    Jianzhong Hu

  7. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York Presbyterian Queens, Flushing, NY, USA

    Daniel W. Skupski

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  1. Yonglin Huang
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Contributions

All authors contributed to the conception and design of the study. The first draft of the manuscript was written by 310 Yong Lin Huang and all authors commented on previous versions of the manuscript. All authors read and 311 approved the final manuscript.

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Correspondence to Yoko Nomura.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research board committee of the City University of New York and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Huang, Y., Zhang, W., Go, K. et al. Altered growth trajectory in children born to mothers with gestational diabetes mellitus and preeclampsia. Arch Gynecol Obstet 301, 151–159 (2020). https://doi.org/10.1007/s00404-020-05436-2

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  • DOI: https://doi.org/10.1007/s00404-020-05436-2

Keywords

  • Gestational diabetes mellitus
  • Preeclampsia
  • Childhood obesity
  • Body mass index
  • Growth trajectory
  • Prenatal origin of childhood obesity