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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.

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



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.


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.


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).


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.


Diabetes; gestational; obesity; paediatric obesity

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