Mild Gestational Diabetes Mellitus and Long-Term Child Health
Article Figures & Tables
Tables
- Table 1
Maternal baseline characteristics by mild GDM treatment group
Characteristic Treated (n = 264) Untreated (n = 236) P value† Age (years) 29.2 ± 5.2 28.7 ± 5.5 0.31 Glucose after 50-g glucose-loading test (mg/dL) 158.2 ± 15.3 158.4 ± 15.4 0.90 Glucose in 3-h OGTT (mg/dL) Fasting glucose 86.9 ± 5.7 86.5 ± 5.6 0.30 1-h OGTT 191.0 ± 21.2 192.9 ± 19.1 0.13 2-h OGTT 172.5 ± 21.4 172.5 ± 18.5 0.79 3-h OGTT 138.2 ± 29.1 133.7 ± 31.6 0.15 BMI at entry (kg/m2) 30.2 ± 5.1 30.6 ± 5.4 0.44 Gestational age at entry (weeks) 28.8 ± 1.6 29.0 ± 1.4 0.34 Race/ethnicity 0.53 Non-Hispanic black 28 (10.6) 27 (11.4) Non-Hispanic white 84 (31.8) 65 (27.5) Hispanic 144 (54.6) 132 (55.9) Other 8 (3.0) 12 (5.1) Data are mean ± SD and n (%). OGTT, oral glucose tolerance test.
↵† Based on the χ2 test for categorical variables and Wilcoxon rank sum test for continuous variables.
- Table 2
Birth outcomes by mild GDM treatment group, overall and by sex
Overall Male Female Outcome Treated (n = 264) Untreated (n = 236) P value† Treated (n = 140) Untreated (n = 121) P value† Treated (n = 124) Untreated (n = 115) P value† Gestational age at delivery (weeks) 38.9 ± 1.8 39.0 ± 1.7 0.30 38.8 ± 1.9 39.2 ± 1.7 0.02 39.1 ± 1.6 38.9 ± 1.7 0.33 Birth weight (g) 3,283.2 ± 491.4 3,468.3 ± 546.4 <0.001 3,285.5 ± 507.2 3,557.6 ± 532.5 <0.001 3,280.6 ± 475.0 3,375.0 ± 547.5 0.08 Macrosomia (>4,000 g) 12 (4.6) 32 (13.6) <0.001 7 (5.0) 21 (17.5) 0.001 5 (4.0) 11 (9.6) 0.09 Fat mass (g) 421.3 ± 173.3 482.9 ± 210.2 <0.001 407.3 ± 152.7 502.0 ± 213.8 <0.001 437.1 ± 193.3 463.3 ± 205.6 0.16 Fat mass >90th percentile 9 (3.8) 36 (16.7) <0.001 1 (0.8) 20 (18.4) <0.001 8 (7.2) 16 (15.1) 0.06 Cord C-peptide (units) 1.2 ± 0.9 1.4 ± 1.5 0.06 1.1 ± 0.7 1.4 ± 1.8 0.06 1.3 ± 1.0 1.3 ± 1.0 0.48 Cord C-peptide >95th percentile 35 (14.8) 48 (22.4) 0.04 15 (12.0) 25 (22.3) 0.03 20 (17.9) 23 (22.6) 0.39 Size for gestational age 0.003 0.003 0.35 Small 16 (6.1) 9 (3.8) 10 (7.1) 4 (3.3) 6 (4.8) 5 (4.4) Appropriate 231 (87.5) 189 (80.4) 123 (87.9) 95 (79.2) 108 (87.1) 94 (81.7) Large 17 (6.4) 37 (15.7) 7 (5.0) 21 (17.5) 10 (8.1) 16 (13.9) Data are mean ± SD and n (%).
↵† Based on the χ2 or Fisher exact test for categorical variables and Wilcoxon rank sum test for continuous variables.
- Table 3
Follow-up outcomes (binomial) by mild GDM treatment group, overall and by sex
Outcome Overall Male Female Treated Untreated Adjusted RR (95% CI)* Treated Untreated Adjusted RR (95% CI)* Treated Untreated Adjusted RR (95% CI)* BMI ≥95th percentile for age and sex 55 (20.8) 54 (22.9) 0.94 (0.68–1.28) 35 (25.0) 30 (24.8) 1.04 (0.70–1.55) 20 (16.1) 24 (20.9) 0.79 (0.48–1.33) BMI ≥85th percentile for age and sex 86 (32.6) 91 (38.6) 0.88 (0.71–1.10) 49 (35.0) 46 (38.0) 0.94 (0.70–1.27) 37 (29.8) 45 (39.1) 0.81 (0.59–1.13) Waist circumference >90th percentile for age, sex, and race/ethnicity 31 (11.7) 27 (11.4) 1.05 (0.65–1.69) 18 (12.9) 15 (12.4) 1.06 (0.56–2.00) 13 (10.5) 12 (10.4) 1.02 (0.49–2.13) Impaired fasting glucose ≥100 mg/dL† 12 (5.7) 13 (7.2) 0.76 (0.36–1.62) 9 (8.4) 2 (2.2) 3.50 (0.78–15.7) 3 (2.9) 11 (12.1) 0.24 (0.07–0.82)‡ Elevated triglycerides ≥100 mg/dL 4–9 years; ≥130 mg/dL 10 years 38 (18.2) 29 (16.0) 1.11 (0.71–1.72) 18 (16.8) 11 (12.2) 1.31 (0.66–2.62) 20 (19.6) 18 (19.8) 0.99 (0.56–1.75) Low HDL cholesterol <40 mg/dL 27 (13.0) 22 (12.2) 1.03 (0.61–1.76) 13 (12.2) 8 (8.9) 1.31 (0.57–3.00) 14 (13.9) 14 (15.4) 0.88 (0.45–1.73) Hypertension ≥95th percentile or age, sex, and height 30 (11.5) 23 (9.8) 1.23 (0.74–2.05) 20 (14.7) 13 (10.7) 1.41 (0.74–2.71) 10 (8.1) 10 (8.7) 0.97 (0.42–2.23) Data are n (%) unless otherwise indicated. RR, relative risk.
↵* All models adjusted for race/ethnicity and log maternal baseline BMI, except waist circumference >90th percentile for age, sex, and race/ethnicity was adjusted only for log maternal baseline BMI. The data presented by child sex are based on multivariable adjusted models that included treatment group, sex, and a treatment group-by-sex interaction term.
↵† P = 0.007 for interaction between treatment group and sex.
↵‡ P = 0.02.
- Table 4
Follow-up outcomes (continuous) by mild GDM treatment group, overall and by sex
Adjusted mean (95% CI) Overall Male Female Outcome Treated Untreated Treated Untreated Treated Untreated BMI z score based on BMI percentile for age and sex 0.33 (0.15–0.51) 0.36 (0.17–0.55) 0.36 (0.12–0.60) 0.34 (0.09–0.60) 0.30 (0.05–0.56) 0.37 (0.10–0.64) Waist circumference (cm)* 57.28 (56.30–58.27) 57.56 (56.54–58.60) 57.69 (56.40–59.02) 58.02 (56.65–59.43) 56.87 (55.52–58.26) 57.10 (55.68–58.57) Fasting glucose (mg/dL)† 88.41 (87.33–89.50) 88.67 (87.56–89.78) 89.64 (88.25–91.04) 87.71 (86.25–89.18) 87.11 (85.65–88.57) 89.62 (88.12–91.12)‡ HOMA-IR*§|| 1.05 (0.94–1.17) 1.10 (0.99–1.24) 1.06 (0.92–1.22) 0.95 (0.81–1.10) 1.05 (0.90–1.22) 1.30 (1.11–1.52)¶ Triglycerides (mg/dL)* 58.91 (54.82–63.30) 57.38 (53.33–61.73) 57.99 (52.83–63.67) 54.85 (49.73–60.51) 60.15 (54.57–66.31) 60.20 (54.45–66.56) HDL cholesterol (mg/dL) 54.35 (52.42–56.28) 55.10 (53.16–57.05) 55.06 (52.60–57.53) 56.65 (54.05–59.26) 53.42 (50.81–56.04) 53.43 (50.77–56.09) Systolic BP (mmHg) 100 (98–101) 100 (98–101) 101 (99–103) 100 (98–102) 99 (97–101) 99 (97–101) Diastolic BP (mmHg) 60 (59–61) 59 (58–60) 60 (59–62) 60 (59–62) 61 (59–62) 58 (57–60)¶ All models adjusted for race/ethnicity and log maternal baseline BMI; log waist circumference also adjusted for child’s sex (overall model) and child’s age in months; log triglycerides also adjusted for child’s age in months; and systolic and diastolic BPs also adjusted for child’s sex (overall model), child’s age in months, and child’s height. The data presented by child sex are based on multivariable adjusted models that included treatment group, sex, and a treatment group-by-sex interaction term. BP, blood pressure.
↵*Back transformation of the log value.
↵†P = 0.002 for interaction between treatment group and sex.
↵‡P = 0.01.
↵§Calculated as (fasting glucose [mmol/L] × fasting insulin [μU/mL]) / 22.5 (20).
↵||P = 0.02 for interaction between treatment group and sex.
↵¶P = 0.04.