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

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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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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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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Keywords

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