A secondary analysis of a mild gestational diabetes mellitus treatment trial long-term follow-up study looked at the relationship between maternal oral glucose tolerance testing and childhood body mass index, fasting glucose, insulin and anthropometrics in the offspring of untreated mild GDM and non GDM assessed at ages five to 10 years.

They concluded that maternal glycemia impacts childhood obesity and metabolic dysfunction.

The study analyzed 236 offspring with untreated mild gestational diabetes mellitus and 481 non GDM. The conclusion was that maternal glycemia is associated with some childhood anthropometric measures of obesity but not with subsequent body mass index, fasting glucose or insulin resistance. However, maternal obesity and Hispanic ethnicity were found to be most associated with childhood obesity and metabolic dysfunction.

"We have known for some time that maternal glycemia has a direct impact on neonatal obesity. This analysis confirms that maternal obesity is far more significant as a risk for childhood obesity than are mild elevations of glucose levels during pregnancy.," stated Mark B. Landon, M.D. with the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network in Bethesda, Md. "This research further suggests that efforts to reduce obesity prior to pregnancy should be emphasized in clinical practice."

Study Design: Secondary analysis of a mild GDM treatment trial long-term follow-up study. The relationship between maternal OGTT (24-31 weeks GA) and childhood BMI, fasting glucose, insulin and anthropometrics (sum of skinfolds (SS), subscapular/triceps ratio (STR), and waist circumference (WC)) in the offspring of untreated mild GDM and non GDM (abnormal 50 g screen/normal OGTT) was assessed at ages 5-10 years. Multivariable regression modeling controlling for maternal and neonatal characteristics was employed.

Results: A cohort of 236 untreated mild GDM and 481 non GDM offspring was analyzed. No differences for childhood fasting glucose, BMI >85th or 95th %ile, skinfolds, waist circumference or HOMA-IR (insulin resistance) was found between mild GDM and non GDM offspring. In the combined cohort, significant Spearman correlations existed between fasting, 1hr, 2hr, and 3hr maternal glucose and STR (all p?.03), in all but 2hr glucose for HOMA-IR (all p?.04) and SS (all p<.03), and in fasting maternal glucose for WC (p=.04) and childhood fasting glucose (p=.03). No correlation was found between OGTT and childhood BMI Z-score. Multivariable regression modeling showed that OGTT was associated with only SS and STR and not with childhood BMI Z-score (Table). Hispanic ethnicity and baseline maternal BMI were most consistently related to childhood BMI Z-score, HOMA-IR, and fasting glucose.

Conclusion: Maternal glycemia is associated with childhood anthropometric measures of obesity but not BMI, fasting glucose, or insulin resistance.

Abstract 30: THE EFFECT OF MATERNAL GLYCEMIA ON CHILDHOOD OBESITY AND METABOLIC DYSFUNCTION by Mark Landon 1Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal- Fetal Medicine Units Network in Bethesda, upcoming on Thursday Feb. 5 in an oral concurrent session at 1:15 p.m. PST, at the Society for Maternal-Fetal Medicine's annual meeting, The Pregnancy Meeting, in San Diego.