Effect of Treatment of Gestational Diabetes Mellitus on Obesity in the Next Generation
- Matthew W. Gillman, MD, SM1,
- Helena Oakey, PHD2,
- Peter A. Baghurst, PHD3,
- Robert E. Volkmer, BA4,
- Jeffrey S. Robinson, FRANZCOG2 and
- Caroline A. Crowther, FRANZCOG2
- 1Obesity Prevention Program, Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, Massachusetts;
- 2Discipline of Obstetrics and Gynaecology, Australian Research Centre for the Health of Women and Babies, University of Adelaide, Adelaide, Australia;
- 3Discipline of Paediatrics and Public Health, Australian Research Centre for the Health of Women and Babies, University of Adelaide, Adelaide, Australia;
- 4Children, Youth, and Women's Health Service, Public Health Research Unit, Adelaide, Australia.
- Corresponding author: Matthew W. Gillman, matthew_gillman{at}hms.harvard.edu.
Abstract
OBJECTIVE Gestational diabetes mellitus (GDM) may cause obesity in the offspring. The objective was to assess the effect of treatment for mild GDM on the BMI of 4- to 5-year-old children.
RESEARCH DESIGN AND METHODS Participants were 199 mothers who participated in a randomized controlled trial of the treatment of mild GDM during pregnancy and their children. Trained nurses measured the height and weight of the children at preschool visits in a state-wide surveillance program in the state of South Australia. The main outcome measure was age- and sex-specific BMI Z score based on standards of the International Obesity Task Force.
RESULTS At birth, prevalence of macrosomia (birth weight ≥4,000 g) was 5.3% among the 94 children whose mothers were in the intervention group, and 21.9% among the 105 children in the routine care control group. At 4- to 5-years-old, mean (SD) BMI Z score was 0.49 (1.20) in intervention children and 0.41 (1.40) among controls. The difference between treatment groups was 0.08 (95% CI −0.29 to 0.44), an estimate minimally changed by adjustment for maternal race, parity, age, and socio-economic index (0.08 [−0.29 to 0.45]). Evaluating BMI ≥85th percentile rather than continuous BMI Z score gave similarly null results.
CONCLUSIONS Although treatment of GDM substantially reduced macrosomia at birth, it did not result in a change in BMI at age 4- to 5-years-old.
Footnotes
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- Received October 2, 2009.
- Accepted January 26, 2010.
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
- © 2010 by the American Diabetes Association.
