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. HillierEmail author
  • Kathryn L. Pedula
  • Kimberly K. Vesco
  • Caryn  E.S. Oshiro
  • Keith K. Ogasawara


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.


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



This work is supported by a Research Award from the American Diabetes Association, and grant award 1R01HD058015 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (both awards to TH). We would also like to thank Martie Sucec for her editorial review and Robin Daily for her formatting assistance.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Teresa A. Hillier
    • 1
    • 2
    Email author
  • 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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