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Int J Epidemiol. 2017 Aug 9. doi: 10.1093/ije/dyx151. [Epub ahead of print]

Offspring risk of obesity in childhood, adolescence and adulthood in relation to gestational diabetes mellitus: a sex-specific association.

Li S1,2, Zhu Y1,3, Yeung E1, Chavarro JE2,4,5, Yuan C2,4,5, Field AE2,4,6,7, Missmer SA2,4,8,6, Mills JL1, Hu FB2,4,5, Zhang C1.

Author information

1
Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD, USA.
2
Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
3
Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
4
Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
5
Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.
6
Division of Adolescent/Young Adult Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
7
Department of Epidemiology, Brown University, Providence, RI, USA.
8
Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.

Abstract

Background:

Animal data suggest sexually dimorphic programming of obesity in response to altered intrauterine environment, but the longitudinal impact of gestational diabetes mellitus (GDM) on sex-specific risk of offspring obesity in humans is unclear.

Methods:

We conducted a prospective analysis of 15 009 US individuals (7946 female and 7063 male) from the Growing-Up Today Study, who were followed from 1996 (ages 9-14 years) through 2010. Height and weight from validated questionnaires were used to derive body mass index (BMI) at different ages. Obesity during childhood (< 18 years) and adulthood (≥ 18 years) were defined using the International Obesity Task Force and the World Health Organization criteria. GDM exposure was identified through self-reported questionnaires from mothers. Relative risks were estimated using multivariable log-binomial regression models with generalized estimating equations accounting for clustering within the same family.

Results:

Male offspring born from pregnancies complicated by GDM had higher BMI compared with non-GDM offspring and had increased risk of obesity; the adjusted relative risk [RR, 95% confidence interval (CI)] was 1.47 (1.11-1.95) for all age groups, 1.59 (1.05-2.41) for late childhood, 1.48 (1.06-2.06) for adolescence and 1.39 (1.00-1.94) for early adulthood. No significant association between obesity and maternal GDM was observed among female participants (RR = 0.97, 95% CI: 0.71-1.33).

Conclusions:

The association of GDM with offspring obesity from late childhood through early adulthood may differ by sex; a significant association was observed among male but not female offspring.

KEYWORDS:

Diabetes; gestational; obesity; paediatric obesity

PMID:
29024955
DOI:
10.1093/ije/dyx151
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