Reduced size at birth and persisting reductions in adiposity in recent, compared with earlier, cohorts of infants born to mothers with gestational diabetes mellitus.
Prentice, Philippa M
Murphy, Helen R
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Prentice, P. M., Olga, L., Petry, C., Simmons, D., Murphy, H. R., Hughes, I., Acerini, C., et al. (2019). Reduced size at birth and persisting reductions in adiposity in recent, compared with earlier, cohorts of infants born to mothers with gestational diabetes mellitus.. Diabetologia, 62 (11), 1977-1987. https://doi.org/10.1007/s00125-019-4970-6
AIMS/HYPOTHESIS: To explore the infancy growth trajectories of ‘recent’ and ‘earlier’ offspring of mothers with gestational diabetes mellitus (OGDM), each compared to the same control infants, and investigate whether ‘recent’ OGDM still exhibit a classical phenotype, with macrosomia and increased adiposity. METHODS: Within a prospective observational birth cohort, 98 ‘earlier’ OGDM born 2001-2009 were identified on 75g oral glucose tolerance testing at 28 weeks gestation, 122 ‘recent’ OGDM born 2011-2013 were recruited postnatally through antenatal diabetes clinics, and 876 normal birth weight infants of mothers with no history of diabetes were recruited across the full study period as controls. All infants followed the same study protocol (measurements at birth, 3, 12, and 24 months, including weight, length, and skinfolds thicknesses indicating adiposity, and detailed demographic data). In all cases, GDM was defined using the International Association of Diabetes and Pregnancy Study Group criteria. RESULTS: ‘Earlier’ OGDM had higher birth weight standard deviation scores (SDS) than controls. Conversely, ‘recent’ OGDM had similar birth weight- and length- SDS to controls (mean+SD: 0.1±1.0 and -0.1±0.9, respectively), but lower mean skinfolds SDS (-0.4+0.6 vs. 0.0+0.9, p<0.001). After birth, ‘earlier’ OGDM showed reduced gains in weight and length between 3-12 months. In contrast, ‘recent’ OGDM had increased weight and skinfolds gains until 3 months, followed by reduced gains in those parameters from 3-12 months, compared to controls. At 24 months, ‘recent’ OGDM remained less adipose than controls (mean skinfolds SDS -0.3+0.7 vs. 0.0+0.8; p<0.001). At all time-points ‘recent’ OGDM had lower growth measurements than ‘earlier’ OGDM. CONCLUSIONS/INTERPRETATION: ‘Recent’ OGDM showed different growth trajectories to the ‘earlier’ group: normalization of birth weight and reduced adiposity at birth, followed by initial rapid weight gain but subsequent reduced adiposity postnatally. While avoidance of macrosomia at birth may be advantageous, the longer-term health implications of these changing growth trajectories are uncertain.
Humans, Diabetes, Gestational, Fetal Macrosomia, Obesity, Birth Weight, Glucose Tolerance Test, Anthropometry, Body Size, Retrospective Studies, Prospective Studies, Life Style, Maternal Age, Pregnancy, Phenotype, Adult, Child, Preschool, Infant, Infant, Newborn, Female, Male, Adiposity
The CBGS has been funded by the Medical Research Council (7500001180, G1001995), European Union Framework 5 (QLK4-1999-01422), the Mothercare Charitable Foundation (RG54608), Newlife Foundation for Disabled Children (07/20), and the World Cancer Research Fund International (2004/03). It is also supported by the National Institute for Health Research Cambridge Biomedical Research Centre. KKO is supported by the Medical Research Council (Unit programme: MC_UU_12015/2).
External DOI: https://doi.org/10.1007/s00125-019-4970-6
This record's URL: https://www.repository.cam.ac.uk/handle/1810/294371
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