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Reduced size at birth and persisting reductions in adiposity in recent, compared with earlier, cohorts of infants born to mothers with gestational diabetes mellitus.

Accepted version
Peer-reviewed

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Type

Article

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Authors

Prentice, Philippa M 
Petry, Clive J 
Simmons, David 
Murphy, Helen R 

Abstract

AIMS/HYPOTHESIS: This study aimed to explore the infancy growth trajectories of 'recent' and 'earlier' offspring of mothers with gestational diabetes mellitus (OGDM), each compared with 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 between 2001 and 2009 were identified using 75 g oral glucose tolerance testing at 28 weeks gestation, 122 recent OGDM born between 2011 and 2013 were recruited postnatally through antenatal diabetes clinics, and 876 normal birthweight infants of mothers with no history of diabetes were recruited across the full study period as the control group. All infants followed the same study protocol (measurements at birth, 3, 12 and 24 months, including weight, length and skinfold thickness 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 birthweight SD scores (SDS) than control infants. Conversely, recent OGDM had similar birthweight- and length SDS to control infants (mean ± SD, 0.1 ± 1.0 and- 0.1 ± 0.9, respectively), but lower mean skinfold thickness 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 and 12 months. In contrast, recent OGDM had increased weight and skinfold thickness gains until 3 months, followed by reduced gains in those variables from 3 to 12 months, compared with control infants. At 24 months, recent OGDM had lower adiposity than control infants (mean skinfold thickness 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, namely normalisation of birthweight 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.

Description

Keywords

Adiposity, Gestational diabetes mellitus, Growth, Infancy, Macrosomia, Maternal hyperglycaemia, Offspring, Skinfold thickness, Weight gain, Adiposity, Adult, Anthropometry, Birth Weight, Body Size, Child, Preschool, Diabetes, Gestational, Female, Fetal Macrosomia, Glucose Tolerance Test, Humans, Infant, Infant, Newborn, Life Style, Male, Maternal Age, Obesity, Phenotype, Pregnancy, Prospective Studies, Retrospective Studies

Journal Title

Diabetologia

Conference Name

Journal ISSN

0012-186X
1432-0428

Volume Title

62

Publisher

Springer Science and Business Media LLC

Rights

All rights reserved
Sponsorship
Medical Research Council (MC_UU_12015/2)
Medical Research Council (G1001995)
Medical Research Council (G0600717)
Medical Research Council (G1001995/1)
Medical Research Council (G0600717/1)
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).