Glucose intolerance and cardiometabolic risk in children exposed to maternal gestational diabetes mellitus in utero.

Publisher: American Academy of Pediatrics Country of Publication: United States NLM ID: 0376422 Publication Model: Print Cited Medium: Internet ISSN: 1098-4275 (Electronic) Linking ISSN: 00314005 NLM ISO Abbreviation: Pediatrics Subsets: MEDLINE

Publication: Elk Grove Village Il : American Academy of Pediatrics
Original Publication: Springfield, Ill., Thomas.

Diabetes Mellitus, Type 2/*epidemiology ; Diabetes, Gestational/*epidemiology ; Glucose Intolerance/*epidemiology ; Metabolic Syndrome/*epidemiology; Age Distribution ; Blood Glucose/analysis ; Case-Control Studies ; Child ; Diabetes Mellitus, Type 2/etiology ; Diabetes Mellitus, Type 2/physiopathology ; Diabetes, Gestational/diagnosis ; Female ; Follow-Up Studies ; Glucose Intolerance/diagnosis ; Glucose Intolerance/physiopathology ; Glucose Tolerance Test ; Hong Kong/epidemiology ; Humans ; Logistic Models ; Male ; Metabolic Syndrome/etiology ; Metabolic Syndrome/physiopathology ; Multivariate Analysis ; Predictive Value of Tests ; Pregnancy ; Prevalence ; Probability ; Risk Assessment ; Sex Distribution

Objective: The goal was to examine the carbohydrate tolerance and cardiometabolic risk among children exposed to maternal gestational diabetes mellitus in utero.
Methods: In this study, 164 Chinese children whose mothers had participated in a previous study on the screening and diagnosis of gestational diabetes mellitus (63 had gestational diabetes mellitus and 101 had normal glucose tolerance during the index pregnancies) underwent follow-up evaluations at a median age of 8 years (range: 7-10 years). Children's weight, height, hip and waist circumferences, and blood pressure were measured, and weight-adjusted oral glucose tolerance tests were performed.
Results: Six children (3.7%) demonstrated impaired glucose regulation or diabetes mellitus at the follow-up evaluation. Children exposed to maternal gestational diabetes mellitus had significantly higher systolic (94+/-1.2 vs 88+/-0.9 mmHg) and diastolic (62+/-0.8 vs 57+/-0.6 mmHg) blood pressure values and lower high-density lipoprotein cholesterol (1.58+/-0.04 vs 1.71+/-0.03 mmol/L) levels, after adjustment for age and gender. A high (>or=90th percentile) umbilical cord insulin level at birth was associated with abnormal glucose tolerance in the offspring.
Conclusions: Maternal gestational diabetes mellitus increases the offspring's cardiometabolic risk, and in utero hyperinsulinemia is an independent predictor of abnormal glucose tolerance in childhood.

0 (Blood Glucose)

Date Created: 20081203 Date Completed: 20090115 Latest Revision: 20171116

20221213

10.1542/peds.2008-0158

19047239