Association of Intrauterine Exposure to Maternal Diabetes and Obesity with Type 2 Diabetes in Youth: The SEARCH Case-Control Study

Abstract

Objective: Limited data exist on the association between in utero exposure to maternal diabetes and obesity and type 2 diabetes (T2D) in diverse youth. These associations were explored in African American (AA), Hispanic (H), and non-Hispanic white (NHW) youth participating in the SEARCH Case-Control (SEARCH CC) study.

Design and Methods: 79 youth with T2D and 190 non-diabetic control youth age 10-22 years attended a research visit. In utero exposures to maternal diabetes and obesity were recalled by biological mothers.

Results: Youth with T2D were more likely to have been exposed to maternal diabetes or obesity in utero than were non-diabetic controls (p<0.0001 for each). After adjusting for offspring age, sex and race/ethnicity, exposure to maternal DM [OR= 5.7; 95% CI=2.4-13.4] and exposure to maternal obesity [2.8; 95% CI=1.5-5.2] were independently associated with T2D. Adjustment for other perinatal and socio-economic factors did not alter these associations. When offspring BMI was added, the OR for the association between in utero exposure to obesity and T2D was attenuated toward the null (OR=1.1; 95% CI=0.5-2.4). Overall, 47.2% (95% CI=30.9%-63.5%) of T2D in youth could be attributed to intrauterine exposure to maternal diabetes and obesity.

Conclusion: Intrauterine exposures to maternal diabetes and obesity are strongly associated with T2D in youth. Prevention efforts may need to target, in addition to childhood obesity, the increasing number of pregnancies complicated by obesity and diabetes.