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Association between maternal gestational diabetes and allergic diseases in offspring: a birth cohort study

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Abstract

Background

Previous studies have linked gestational diabetes (GDM) with allergies in offspring. However, the effect of specific glucose metabolism metrics was not well characterized, and the role of polyunsaturated fatty acids (PUFAs), a modifier of metabolism and the immune system, was understudied. We aimed to investigate the association between maternal GDM and allergic diseases in children and the interaction between glucose metabolism and PUFAs on allergic outcomes.

Methods

This prospective cohort study included 706 mother–child dyads from Guangzhou, China. Maternal GDM was diagnosed via a 75-g oral glucose tolerance test (OGTT), and dietary PUFAs were assessed using a validated food frequency questionnaire. Allergic disease diagnoses and the age of onset were obtained from medical records of children within three years old.

Results

Approximately 19.4% of women had GDM, and 51.3% of children had any allergic diseases. GDM was positively associated with any allergic diseases (hazard ratio [HR] 1.40; 95% confidence interval (CI) 1.05–1.88) and eczema (HR 1.44; 95% CI 1.02–1.97). A unit increase in OGTT after two hours (OGTT-2 h) glucose was associated with an 11% (95% CI 2%–21%) higher risk of any allergic diseases and a 17% (95% CI 1–36%) higher risk of food allergy. The positive associations between OGTT-2 h glucose and any allergic diseases were strengthened with decreased dietary a-linolenic acid (ALA) and increased n-6 PUFAs, linoleic acid (LA), LA/ALA ratio, and n-6/n-3 PUFA ratio.

Conclusions

Maternal GDM was adversely associated with early-life allergic diseases, especially eczema. We were the first to identify OGTT-2 h glucose to be more sensitive in inducing allergy risk and that dietary PUFAs might modify the associations.

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Data availability statement

The datasets generated during and/or analyzed during the current study are not publicly available due to individual privacy, but are available from the corresponding author on reasonable request.

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Acknowledgements

We thank all the participating families and the research assistants involved with our study.

Funding

This research was supported by the Key-Area Research and Development Program of Guangdong Province (2019B030335001), the Natural Science Foundation of Guangdong Province, China (2023A1515030192), and the “Nutrition and Care of Maternal & Child Research Fund Project” of Biostime Institute of Nutrition & Care (2021BINCMCF053).

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Authors and Affiliations

  1. Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong Province, People’s Republic of China

    Yu-Jing Chen, Bi-Bo Jiang, Xiao-Xu Li, Nan Liu, Jin Jing & Li Cai

  2. Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, People’s Republic of China

    Li-Zi Lin

  3. Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, People’s Republic of China

    Zhao-Yan Liu

  4. Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-Sen University, Guangzhou, People’s Republic of China

    Zhao-Yan Liu & Li Cai

  5. Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China

    Xin Wang

  6. Faculty of Health and Behavioural Sciences, Pharmacy Australia Centre of Excellence, University of Queensland, Woolloongabba, QLD, Australia

    Shamshad Karatela

  7. Global Health Research Center, Duke Kunshan University, Kunshan, People’s Republic of China

    Yu-Xuan Wang

  8. Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, People’s Republic of China

    Shan-Shan Peng

  9. Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, People’s Republic of China

    Xin Wang

  10. Institute of Tropical Health and Medicine (AITHM), James Cook University, Townsville, QLD, Australia

    Shamshad Karatela

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  1. Yu-Jing Chen
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Contributions

LC: conceptualizaion, methodology, investigation, data curation, formal analysis, resource, supervision. YC: conceptualizaion, methodology, investigation, data curation, formal analysis, visualization, writing–original draft. LL: conceptualizaion, methodology, writing–review and editing. SP, BJ, XL, NL: investigation, data curation, formal analysis. YW: visualization. SK, XW, ZL: writing–review and editing. JJ: writing–review and editing, resource, supervision.

Corresponding author

Correspondence to Li Cai.

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No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.

Ethical approval

This study was approved by the ethics committee of the School of Public Health, Sun Yat-sen University (approval number: SYSUSPH2021121). Informed consent to participate in the study have been obtained from participants.

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Chen, YJ., Lin, LZ., Liu, ZY. et al. Association between maternal gestational diabetes and allergic diseases in offspring: a birth cohort study. World J Pediatr 19, 972–982 (2023). https://doi.org/10.1007/s12519-023-00710-0

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